111 Main St.
Los Angeles, CA 90034
January 10, 2013
Mr. John Smith
545 Maple Dr.
Los Angeles, CA 98543
Dear Mr. Smith,
I, Jane Doe, am writing this letter to indicate that I authorize Joe Clark to act on my behalf with
regard to checking account #1234567890 while I am out of town between the dates of February
1, 2013 and March 31, 2013.
I appreciate both your and Mr. Clark’s assistance in this matter.
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