LETTER OF AUTHORIZATION AND REPRESENTATION
COMPANY NAME: ________________________________ ADDRESS: CITY/ST/ZIP: ________________________________ ________________________________
PHONE NUMBER: FAX NUMBER: EMAIL ADDRESS:
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FEDERAL EMPLOYER ID NUMBER: DEALER LICENCE #: SALES TAX EXEMPT #:
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I HEREBY AUTHORIZE TITLE CONSULTANTS TO ACT AS OUR AGENT AND REPRESENT US FOR ALL TITLE MATTERS TO BE SUBMITTED FOR TRANSFER INTO OUR NAME.
______________________________ REP. SIGNATURE & TITLE ______________________________ PRINTED NAME OF REP.
__________________ DATE