Authorization Letter printable pdf download

Authorization Letter

Date :

To: University of Macau, Finance Office

Dear Sir / Madam,

I, __________________________ hereby authorize the following representative to

Collect the refund on my behalf from you. The following documents will be attached.

Student’s information:

Student Name: ___________________________ Student No: _________________

Name of Degree &Major: ________________________________________________

Contact Address: _______________________________________________________

Contact Telephone No: _____________ Email Address: ______________________

Authorized Items:

 Tuition Fee;  Dormitory Fee;  Dormitory Caution Fee;

 Others: ____________________________________________ (Please specify)

______________________________

Student’s Signature

Authorized Person’s information

Name: ________________________ Identification Document: ________________

ID Number: _______________________

Local Bank: _______________________ Bank Account: ________________________

Contact Address: _______________________________________________________

Contact Telephone no: _____________ Email Address: _______________________

______________________________

Authorized Person’s Signature

(FO-07/2014)

Authorization Letter