Authorization Letter Template

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Your Name

Street Address, City, ST ZIP
[email protected] · (123) 456‑7890


October 23, 2025

Recipient Name
Title
Company
Street Address
City, ST ZIP

To Whom It May Concern,

I, [Your Full Name], hereby authorize [Authorized Person Name], holding [ID Type] [ID Number], to request and receive an official copy of my Birth Certificate from [Civil Registry/Office].

This authorization is valid from [Start Date] to [End Date]. Attached are photocopies of my valid ID and the authorized representative’s ID for verification.

Thank you for your assistance.

Sincerely,


Your Name