Authorized Item Pickup Authorization Form
Complete this form to authorize another individual to pick up an item on your behalf. All information must be accurate to ensure a smooth and secure pickup process.
Your Full Name
*
First Name
Last Name
Your Email Address
*
example@example.com
Your Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Authorized Person's Full Name
*
First Name
Last Name
Authorized Person's Email Address
example@example.com
Authorized Person's Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Item Description
*
Reference or Order Number (if applicable)
Pickup Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Signature of Authorizing Person
*
Submit Authorization
Submit Authorization
Should be Empty: