Authority To Act As Agent printable pdf download

Authority To Act As Agent

THIS MUST BE SIGNED BY THE APPLICANT AND SHOULD BE PLACED ON

APPLICANTS LETTERHEAD ONLY IF AGENT IS SUBMITTING APPLICATION

Authority to Act as Agent

Date: ________

American Certification Body, Inc.

6731 Whittier Avenue

Suite C110

McLean, VA 22101

To Whom It May Concern:

______(Insert Lab/Personnel

or Agent Name Here)______ is authorized to act on our behalf, until

otherwise notified, for applications to American Certification Body, Inc. (ACB).

We certify that we are not subject to denial of federal benefits, that includes FCC benefits, pursuant to

Section 5301 of the Anti-Drug Abuse Act of 1988, 21 U.S.C. 862. Further, no party, as defined in 47

CFR 1.2002

(b),

to the application is subject to denial of federal benefits, that includes FCC benefits.

Thank you,

Agency Agreement Expiration Date: _____(Typically 8 – 12 months)_____

By:

__________________________

________________________

(Signature

)

(Print name)

Title:

__________________________

On behalf of: __________________________

(Company Name)

Telephone:

__________________________

- If a group “entity” is designated as the authorized agent, the letter of authorization must identify those individuals within

the group who are authorized to take action on the application; or alternatively a statement must be provided indicating

that as the authorized agent, any individual within the group “entity” is authorized to act on behalf of the applicant /

grantee and take action on the application. See

https://apps.fcc.gov/oetcf/kdb/forms/FTSSearchResultPage.cfm?switch=P&id=33316

Must be signed by applicant contact given for applicant on the FCC site, or by the authorized agent if an appropriate

authorized agent letter has been provided. Letters should be placed on appropriate letterhead.

020415 – 08

Authority To Act As Agent