Authorization Letter (Free Samples)
Use these sample authorization letters as templates for your formal letter.
Last updated on September 21th, 2021
Sample 1 - Authorization Letter
First Party’s Name
First Party’s Address
City, State, Zip Code
DATE
Second Party’s Name
Name of Bank
Second Party’s Address
City, State, Zip Code
Dear Second Party’s Name:
This letter is a formal authorization for Name of Third Party to access my checking account NUMBER at Name of Bank to make my mortgage and car loan payments while I am on vacation between DATE and DATE.
If you have any questions, I can be reached at Phone Number or at Email Address at any time, even while I am on vacation.
I appreciate your help in this matter.
Sincerely,
First Party’s Signature
First Party’s Printed Name
Sample 2 - Authorization Letter
Name of Parent
Address of Parent
City, State, Zip Code
DATE
Name of Babysitter
Address of Babysitter
City, State, Zip Code
RE: Authorization for Medical Treatment of Name of Child
To Whom It May Concern:
The intent of this letter is to give Name of Babysitter the authorization to take my four-year-old son Name of Son to Name of Doctor, Address of Doctor and Phone Number or Name of Hospital, Address of Hospital and Phone Number if there is a medical emergency or medical attention is required when I am not available.
Name of Babysitter is also permitted to give Name of Son OTC children’s Tylenol if he develops fever before reaching the doctor or hospital. Name of Son has no known in tolerances or allergies to any medication.
If required by the hospital or doctor, Name of Babysitter has permission to give Insurance Information. This authorization becomes invalid when Name of Babysitter is no longer in my employ.
Sincerely,
Parent’s Signature
Parent’s Name Printed and Relation to the Child i.e. mother, father of child
Date of signing
Copies to: Name of Hospital, Name of Doctor, Name of Babysitter, Name of Insurance Agent or Company
Sample 3 - Authorization Letter
Name of Legal Guardian
Address of Legal Guardian
City, State, Zip Code
DATE
RE: Medical Treatment Authorization
To Whom It May Concern:
I, Name of Legal Guardian, am the lawful guardian of the female child named below. I give permission and consent to Name, Address and Phone Number of Temporary Caregiver to authorize medical treatment for Full Name of Child and date of birth. This permission is granted from DATE and will expire on DATE.
Signature Of Legal Guardian DATE
Printed Name of Legal Guardian
Signature of Witness or Notary (if required by the state) DATE
Printed Name of Witness
By Andre Bradley
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