Date (ie. July 31, 2000)
BY FAX Bank Name Bank Address Attention: Name of Bank Representative or Manager Dear Sir or Madam: You are hereby authorized and directed to release to Name of Person to whom you wish to have Account Information Released all banking information requested by him relating to our Account No. Account No. (ie. 12345678). This shall be your good and sufficient authority for so doing. Yours truly, Your Company or Business Name
Your Name