Authorization Letter for Personal Information

Allen Sampson
123 Liberty Lane
Newtown, NT 54321
[email protected]
October 15, 2023

To Whom It May Concern,

I, Allen Sampson, residing at 123 Liberty Lane, Newtown, NT 54321, hereby authorize [Authorized Person’s Full Name], holding identification number [ID Number], to access and obtain my personal information held by your organization. This includes, but is not limited to, my employment records, medical records, and financial details.

This authorization is provided to facilitate [specific reason, e.g., “my application for a home loan with XYZ Bank”]. I understand the sensitivity and confidentiality of the personal information being accessed and trust that it will be handled with the utmost care and used solely for the purposes mentioned.

Please note that [Authorized Person’s Full Name] is permitted to make copies of documents and take notes as necessary during this process. This authorization is valid from the date of this letter until [End Date or “until further notice”], at which point it will automatically expire unless explicitly renewed in writing.

Should you require any additional verification or have questions regarding this authorization, please do not hesitate to contact me directly at [email protected] or by phone at (555) 555-5555.

Thank you for your cooperation and assistance in this matter.


Allen Sampson

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