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Date

Receipient Address 1
Receipient Address 2
Receipient Address 3

Dear Sir / Madam

LETTER OF AUTHORIZATION

I, <your name> ID card <your ID card number> hereby authorize Mr. / Ms. <name>,
ID card <ID card number>, to retrieve my insurance information and other related
information for me to surrender my policy. Kindly provide him / her with all the details.
Should you have further enquiries, please do not hesitate to call me at <your contact
number> .

Thank you

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Your Name
Title

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