Brand Owner Authorization Letter Form
Complete this form to authorize a representative to act on behalf of your brand.
Brand Owner's Full Name
*
First Name
Last Name
Brand Owner's Email Address
*
example@example.com
Brand Name
*
Brand Owner's Company (if applicable)
Authorized Representative's Full Name
*
First Name
Last Name
Authorized Representative's Email Address
*
example@example.com
Scope of Authorization (describe specific actions or roles authorized)
*
Authorization Validity Period (start and end date)
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Authorization Declaration: I, as the brand owner, hereby authorize the above representative to act on behalf of the brand as described.
*
I confirm and authorize
Signature of Brand Owner
*
Submit Authorization
Submit Authorization
Should be Empty: