[Your Name]
[Your Address]
[City, State, ZIP Code]
[Email Address]
[Phone Number]
[Date]
[Recipient’s Name]
[Recipient’s Position]
[Company’s/Organization’s Name]
[Company’s/Organization’s Address]
[City, State, ZIP Code]
Subject: Authorization for Third-Party Representation
Dear [Recipient’s Name],
I, [Your Name], residing at [Your Address], hereby authorize [Authorized Person’s Name], residing at [Authorized Person’s Address], to act on my behalf in matters related to [specific purpose, e.g., legal, financial, medical, etc.] with [Company’s/Organization’s Name].
This authorization includes the following actions:
- Representation: Represent me in all matters related to [specific purpose].
- Documentation: Sign all necessary documents and forms.
- Communication: Communicate with [Company’s/Organization’s Name] on my behalf.
This authorization is effective from [start date] to [end date] or until revoked by me in writing. The purpose of this authorization is to ensure the efficient handling of my affairs during my absence due to [reason, e.g., travel, work commitments, health issues].
Attached are copies of my identification and [Authorized Person’s Name]’s identification for verification purposes. Should you require any further information or have any questions, please contact me directly at [your phone number] or [your email address].
Thank you for your cooperation.
Sincerely,
[Your Name]
[Signature]