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Authorization Form

The undersigned, _____________________, hereby authorizes ________________ (name, names or firm) to enter the premises at ____________________ on __________
(Date) and remove the following specific articles: _______________________________
______________________________________________________________________


This shall be your good and sufficient authority for so doing, which authority shall expire on _______________ (Date) at ________________ (time).

Give this authorization to: _____________________ at _________________ (Location)


_________________________
Authorized Person                                Dated:

_________________________
Witness

Authorization #: ____________