Free Authorization Letter 42
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Authorisation letter
To whom it may concern,
I (account owner)
*Title

*First name

Middle name

*Family name

Account no.

*Alternative contact number

*Email:

am authorising (authorised person)

*Title
*ID type:

*Gender:

*First name
National ID
Passport

Male
Female

Middle name

*Family name

*ID/Passport no.

*Visa type

*Nationality

*Visa number

*Date of birth

DD

MM

*ID/Passport expiry date

YYYY

*Alternative contact number

DD

MM

YYYY

*Email:

Documents required
Passport / national ID of the account owner
Passport / national ID of the authorised person

I authorise the above to act on my behalf for the above account
in any aspect of this account,including any application, amendments or cancellation of any associated services.

AP-AL- ENG-OCT-12

to make the following amendment to my du service:

*Account owner’s signature

*Date

*Authorised person’s signature

*Date

DD

MM

YYYY

DD

MM

YYYY