Pickup Authorization

Letter of Authorization
Purchaser's Name*

First NameLast Name
Authorized Representative's Name*

First NameLast Name
Type of Trailer*
E-mail Address*
example@example.com
Phone Number*
Format: (000) 000-0000.
I, {purchasersName} , designate {authorizedRepresentatives} as my authorized representative to sign for and collect the {typeOf} on my behalf.
Signature*

Clear
Date*

MonthDayYear
Date
Please verify that you are human*
Should be Empty:

Letter of Authorization