Authorization Letter For Birth Certificate 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