Authorization Letter for Utility Services

Karla Young
789 Ocean Drive
Miami, FL 33139
Email: [email protected]
Phone: (305) 555-0123
Date: October 15, 2023

Release Authorization

To Whom It May Concern,

I, Karla Young, residing at 789 Ocean Drive, Miami, FL, hereby authorize the release of my [specify the documents or information, e.g., medical records, employment documents] to [Recipient’s Name or Organization], represented by [Individual’s Name if applicable], located at [Recipient’s Address or Organization’s Location].

This authorization applies to documents and information covering the period from [Start Date] to [End Date or “present”]. The purpose of this release is to [briefly describe the purpose, e.g., “facilitate my application for employment with XYZ Corporation”].

I understand that the released information may contain sensitive and confidential data. By signing this letter, I waive any right to privacy or confidentiality regarding the disclosed information to the extent of this authorization. I also acknowledge that this letter does not permit the release of any information beyond what is specified herein.

Please direct any communications regarding this authorization to me directly at the contact information provided above. This authorization is valid until [Specify Expiration Date], after which no further releases should be made without my explicit consent.

Thank you for your prompt attention to this matter. Should you require any additional information or verification, please do not hesitate to contact me.

Sincerely,

[Signature]
Karla Young

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