This is an agreement between an employer and an employee whereby the employer
authorizes the employee to work for them. This agreement can be customized to
provide for the specific work that the employer authorizes the employee to undertake.
This agreement notifies third parties that the employee is a party of interest and is
authorized to work on behalf of the employer. In addition, this agreement provides an
arbitration clause requiring any controversy concerning the agreement to be submitted
to arbitration rather than court proceedings. This document can be used by an
individual or small business that wants to authorize another party to complete specified
WORK AUTHORIZATION AGREEMENT
___________________ [Instruction: insert name of entity granting authorization] (“Granting
Party”) hereby authorize ___________________ [Instruction: insert name of entity receiving
authorization] (“Authorized Party”) to _____________________ [Instruction: insert detailed
description of work that is being authorized].
Any third party receiving a copy of this agreement is directed to recognize Authorized Party as a
party of interest.
Granting Party has a Right of Rescission to cancel this agreement without any penalty or
obligation within _____ [three (3)] [Comment: This number is not provided for by law, but
can be any number the user chooses] business days from the above date. You must deliver the
signed and dated Notice of Cancellation or any other written notice to Authorized Party. This
must be executed no later than midnight on ___________________ [Instruction: insert date].
Any controversy concerning this Agreement shall be determined by arbitration upon the
initiation of either party, and shall be settled and finally determined by an arbitrator mutually
acceptable to both parties. If the parties are unable to agree upon a single arbitrator, each party,
as its own cost and upon notice to the other party, shall appoint one arbitrator. If a party does not
appoint an arbitrator within _____ [five (5)] [Comment: This number is not provided for by
law, but can be any number the user chooses] business days after the other party has given
notice of the name of its appointed arbitrator, the single arbitrator first appointed shall be the sole
arbitrator, and that arbitrator's decision shall be binding upon both parties. If two arbitrators are
appointed, they shall appoint a third arbitrator, and the three shall resolve the question. The
written decision of any two of the arbitrators so appointed shall be binding and conclusive on the
parties hereto and enforceable in any court of competent jurisdiction. The appointment of the
third arbitrator shall be made within _____ [five (5)] [Comment: This number is not provided
for by law, but can be any number the user chooses] business days following the appointment
of the first two arbitrators. If the two arbitrators first appointed cannot agree upon a third, that
third arbitrator shall be chosen by the Presiding Judge of the ___________________
[Instruction: insert Court] Court of the County of ___________________ [Instruction: insert
county], State of ___________________ [Instruction: insert state]. Each of the parties shall
bear one-half of the cost of appointing the third arbitrator, and of paying the third arbitrator's fee.
______________________________________________________ [Instruction: insert any
I have received a copy of the detached Notice of Cancellation.
___________________ [Instruction: insert signature of Granting Party]
Signature of Granting Party
___________________ [Instruction: insert signature of Authorized Party]
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