Free template · Updated October 18, 2026

Letter of Authorization template

A letter of authorization lets a named representative act for you on one specific, limited task, such as collecting documents, picking up goods, or talking to a provider about a named account, for a set period, with identification details and a right to revoke.

A letter of authorization is a short signed letter in which one person or company allows another person or company to act on their behalf for a specific, limited task, such as collecting documents, picking up goods, dealing with a utility provider, or discussing a named matter with a bank or landlord. You need one when an organization will only deal with the account holder unless they confirm in writing that someone else may step in.

Use this template — sign onlineOpens as a ready-to-send document with signature fields placed.

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1. Letter Details

Date: [DATE] To: [RECIPIENT ORGANIZATION NAME], [DEPARTMENT, if known], [RECIPIENT ADDRESS OR EMAIL] Re: Letter of Authorization for [SHORT DESCRIPTION OF THE TASK], account or reference number [ACCOUNT / REFERENCE NUMBER, or NOT APPLICABLE]

2. Person Giving Authorization

I, [YOUR FULL LEGAL NAME] [or: (COMPANY NAME), a (TYPE OF ENTITY) acting through (SIGNER NAME, TITLE)], of [ADDRESS], phone [PHONE], email [EMAIL] (the "Authorizing Party"), am the [ACCOUNT HOLDER / OWNER / CUSTOMER / APPLICANT] for the matter described in this letter.

3. Authorized Representative

I authorize [REPRESENTATIVE FULL NAME] [or: (COMPANY NAME), through its employee (NAME)], of [REPRESENTATIVE ADDRESS], phone [PHONE] (the "Representative"), to act on my behalf as described in section 4. The Representative's relationship to me: [FAMILY MEMBER / EMPLOYEE / CONTRACTOR / AGENT / OTHER]. The Representative will present [GOVERNMENT-ISSUED PHOTO ID / COMPANY ID / REFERENCE CODE] when acting under this letter, and this ID will show the name above.

4. Scope of Authorization

The Representative may do only the following on my behalf: [SPECIFIC TASK(S), for example: collect the original documents for application number (NUMBER); pick up the order (ORDER NUMBER); discuss the billing on account (NUMBER) and request a payment plan; receive copies of (DOCUMENTS)]. The Representative may sign receipts and routine acknowledgments needed to complete these tasks.

5. Limits

This letter does not authorize the Representative to: [OPEN OR CLOSE ACCOUNTS / CHANGE ACCOUNT HOLDER, CONTACT, OR PAYMENT DETAILS / MAKE OR RECEIVE PAYMENTS / SIGN CONTRACTS OR AGREE TO NEW TERMS / ACCESS ANY OTHER ACCOUNT OR MATTER / ANY OTHER LIMIT]. Anything not listed in section 4 is excluded. This letter is not a power of attorney and does not give the Representative general authority to make legal or financial decisions for me.

6. Duration and Revocation

This authorization takes effect on [START DATE] and ends on [END DATE], or when the task in section 4 is completed, whichever comes first [or: for one use only]. I may revoke it earlier at any time by written notice to [RECIPIENT ORGANIZATION] at [CONTACT DETAILS]; revocation takes effect when the recipient receives it and does not affect actions already taken in reliance on this letter.

7. Verification and Contact

To verify this letter, please contact me at [PHONE] or [EMAIL]. A copy of my identification [IS ATTACHED / CAN BE PROVIDED ON REQUEST]. If your organization requires its own authorization form, notarization, or additional documents for this task, please tell me and I will provide them.

8. Electronic Signature

I agree that this letter may be signed electronically and that an electronically signed copy has the same effect as the original, unless the recipient requires a different form of signature.

9. Signatures

AUTHORIZING PARTY: [YOUR FULL NAME] [and TITLE, if signing for a company] Signature: ____________________ Date: [DATE] ACKNOWLEDGED BY THE REPRESENTATIVE (optional): [REPRESENTATIVE NAME] Signature: ____________________ Date: [DATE]

Our take: Our take: a letter of authorization works because it is narrow. Name the representative, name the task, name the account or reference number, and give it an end date; a letter that says "may act for me in all matters" is trying to be a power of attorney, and most institutions will refuse it. It is not a power of attorney. A power of attorney is a formal legal document, often with state-specific wording, signing, witness, or notarization requirements, that lets an agent make legal and financial decisions for you, such as signing contracts, selling property, or managing bank accounts over time. If that is what you need, use a power of attorney prepared under your local law. Some institutions also insist on their own forms: in the US, the IRS uses Form 8821 to let someone receive your tax information and Form 2848 to authorize someone to represent you before the IRS, and healthcare providers generally need a HIPAA authorization that names the information, who may disclose it and to whom, the purpose, an expiration date or event, and your signature and date. Banks, government offices, and courts may ask for a notarized or wet-ink letter. Ask the recipient what they accept before you send anything.

When should you use a letter of authorization?

When someone else needs to collect documents, keys, a parcel, or goods on your behalf
When a family member, assistant, or contractor must deal with a utility, landlord, or service provider about a named account
When a company authorizes an agent, broker, or contractor to submit or obtain records for a specific matter
When you are traveling or unavailable and want one task handled without giving broad legal authority

How do you fill in this template?

Ask the recipient first whether they accept a letter of authorization for this task, or whether they require their own form, a notarized letter, or a power of attorney.
Fill in the account or reference number and describe the task in section 4 as narrowly as you can.
List what the representative may not do in section 5, especially anything involving money, contracts, or account changes.
Set a start and end date, or make it single use, and add your contact details so the recipient can verify the letter.
Attach a copy of your ID if the recipient asks for one, and tell the representative to bring their own.
Upload the letter to eSignSimple, save it as a template if you send similar letters often, and send it for e-signature, adding the representative as a second signer if you want their acknowledgment.

How do you get it signed online?

Save it as Word or PDF. Paste the filled-in text into Word or Google Docs and keep it as a .docx file, or export it as a PDF. eSignSimple accepts both, plus DOC, ODT and RTF, up to 25 MB; Word files are converted to PDF on upload.
Upload and place the fields. Sign up with Google, upload the file and drag signature, initials, date and text fields onto the page for each signer. Set a signing order if one party must sign first.
Send it for signature. Each signer gets a private link and signs in the browser without creating an account. Automatic email reminders go out every three days (up to three) until everyone has signed.
Keep the signed copy. When the last person signs, everyone can download the final PDF with a certificate of completion, an audit trail and a SHA-256 fingerprint you can verify later.

Signing on your own device only? The guide to signing a PDF covers the free built-in options, and the security page explains how signed files are stored and verified.

This template is general information, not legal advice. Laws differ by country and state; have a lawyer review contracts with high stakes.

Written by Buğra Sözeri, founder and editor, eSignSimple · Last reviewed October 18, 2026

Buğra builds eSignSimple and writes and maintains its guides. He researches each legal page against the official texts linked on it and updates pages when the law or the product changes. He is not a lawyer, and nothing here is legal advice. About eSignSimple

Frequently asked questions

Is a letter of authorization the same as a power of attorney?

No. A letter of authorization permits a specific, limited task and is accepted at the recipient's discretion. A power of attorney is a formal legal document that gives an agent authority to make legal or financial decisions for you, and it often has to meet state-specific requirements, such as particular wording, witnesses, or notarization. If you need someone to sign contracts, manage bank accounts, or deal with property for you, you probably need a power of attorney.

Does a letter of authorization need to be notarized?

Usually not, but some recipients ask for it, especially banks, government offices, and anyone releasing valuable property or records. Ask them before you sign. See our glossary entry on notarization for what a notary actually checks.

Will my bank or the IRS accept this letter?

Often not for anything important. Banks commonly have their own third-party authorization or power-of-attorney forms. In the US, the IRS uses Form 8821 for tax information authorizations and Form 2848 for representation, and healthcare providers generally need a HIPAA authorization. Use the institution's form when it has one.

How do I cancel a letter of authorization?

Send written notice of revocation to the organization that received the letter, and tell the representative. Section 6 of this template explains that revocation takes effect when the recipient receives it.

Can I sign a letter of authorization electronically?

In many cases, yes, and an e-signed letter with an audit trail is easy to verify. Some institutions still require a wet-ink or notarized signature for certain tasks, so check with the recipient before you rely on it.

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