Psa Authorization Letter

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AUTHORIZATION LETTER (PSA)

TO COLLECT BIRTH CERTIFICATE


Date : September 19, 2022

Subject : {{Subject}}

Dear Sir/Madam {{Name}}, / To whom it may concern,

I hereby authorize {{authorized person’s name}} to collect the PSA-issued birth certificate that was
issued on {{issued date}} on my behalf.

I am the document owner’s {{RELATIONSHIP}}, to receive the PSA-issued birth certificate of {{NAME OF
THE CERTIFICATE OWNER}} because the document owner is not of legal age yet, hence, he cannot
receive the requested birth certificate {{himself/herself}}.

Below you can see the printed scans of valid IDs of both the authorized representative and the
document owner which are necessary to receive the delivered document and for verification purposes.
Listed below are the collector’s name and identity proof details for your reference and verification
process.

Collector’s Name: {{Name}}


Collector’s Identity Type: {{Passport}}
Collector’s Identity Number: {{ID number}}
Collector’s Signature:

You may contact me for further queries via {{Phone number}}.

I would be very grateful to you if this could be arranged as soon as possible.

Yours sincerely,

{{Signature}}

{{Formal Name}} {{Title}}


APPENDIX

Valid ID of the Document Owner

Front and Back of {{ID Document 1}}:

{{PUT SCANS HERE}}

Valid ID of the Authorized Representative

Front and Back of {{ID Document 2}}:

{{PUT SCANS HERE}}

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NOTICE ALLBUSINESSTEMPLATES.COM
The information in this document is designed to provide an outline that you can follow when formulating business or personal plans.
Due to the variances of many local, city, county and state laws, we recommend considering professional legal counseling before entering into any
contract or agreement. AllBusinessTemplates.com herewith expressly rejects any liability incurred due to the use of any documents provided on its
website.

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