Sample Authorization Letter printable pdf download

Sample Authorization Letter

Rev 9.29.09

SAMPLE AUTHORIZATION LETTER

ABC Company

(LETTERHEAD)

Month, Day, Year

U.S. Department of State

Directorate of Defense Trade Controls

PM/DDTC SA-1, Room 1200

2401 E Streets, NW

Washington, DC 20037

SUBJECT: Letter for a Commodity Jurisdiction (CJ) Request authorizing

XYZ Company to file on behalf of the ABC Company for the (Insert

the product name)

Dear Sir or Madam:

The XYZ Company is authorized to submit a CJ request to the Directorate of Defense Trade

Controls (DDTC) on behalf of the ABC Company for the following product (Insert the product

name and provide brief details such as hardware, software, service, etc.). (Insert specific

individuals at XYZ Company, if appropriate, who will be involved). (Insert and explain the

nature of the relationship between the two companies, e.g., the ABC Company hired the XYZ

Company to file on its behalf or, the ABC Company is a subsidiary of the XYZ Company or,

joint production of the product or, the manufacturer has gone of out of business or, XYZ

Company sells item manufactured by ABC Company or, Companies ABC and XYZ have other

specified business arrangement or relationship, etc.). (If the form does not list an Applicant or the

Submitter does not include an Authorization letter from the Applicant, the letter should explain

why such authorization has not been provided so that DDTC may determine if the CJ request may

be processed.)

The ABC Company authorizes the release for general publication of the information contained in

Block 5 of the DS-4076 Form, as prepared and submitted by the XYZ Company (this release

applies specifically to the DS-4076 form).

(Closing Statement,)

(Signature Line)

Name

Title

Telephone number and email

ABC Company

123 Streets

Town, State, Zip

(Contact information is important so that DDTC can contact the manufacturer directly, if

necessary.)

Sample Authorization Letter