Authorization

To Whom It May Concern:

The undersigned hereby authorizes Name of Person Receiving Authorization to Description of

Activity being Authorized (ie. utilize the undersigned's credit card for purchases up to $500.00
and to sign the undersigned's name on credit card vouchers).

This Authorization shall be valid from the date set forth below and shall terminate on Date of
Termination of Authorization.

You may rely upon this Authorization in connection with any dealings you may have with Name
of Person Receiving Authorization.

Dated Date of Authorization.

Witness Name of Person Giving Authorization