Basic Information

1. Letter Date *

2. Your Name *

3. Your ID Number

4. Your Contact Number/Email *

Representative Information

5. Name of Representative *

6. Representative ID Type

7. Representative ID Number

Recipient Information

8. Name of Recipient

Authorization Details

9. Start Date *

10. End Date *

11. Purpose of Authorization *

12. Reason for Inability

13. Scope of Authorization *

Optional Information

14. Your Signature

15. Optional Clauses

16. Witness Name (if required)

17. Notary Public (if required)

AUTHORIZATION LETTER

Date: September 13, 2025

To Whom It May Concern,

I, [Your Name], authorize [Name of Representative] to [Purpose of Authorization].

This authorization is effective from [Start Date] to [End Date] unless otherwise revoked or modified in writing.

During the authorized period, [Name of Representative] is empowered to take necessary actions within the defined scope of authority. They are authorized to [Scope of Authorization].

For verification, [Name of Representative] will present their [type of ID] with ID number [Representative ID number] (if required).

Thank you for your attention to this matter. In case you have any queries, do not hesitate to reach out at [Your Contact Number/Email].

[Optional Clauses] (if required)

Witnessed by: [Witness Name] (if required)

Notary Public: [Notary Public] (if required)

Signature Name

ID No: [Your ID Number] (if Required)