Letter Of Authorization

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LETTER OF AUTHORIZATION
Drivers License # ______________
I, _____________________________, do hereby give
(Insured’s Name)
_____________________________ Permission to sign on my behalf in the renewal of
(Designated Signer)
my Drivers License.
My Permanent Address is: _____________________
_____________________
_____________________
My Mailing Address is:
_____________________
_____________________
_____________________
Date:__________________
Signature: X__________________________

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