Authorization Form - TRUSTED MOVERS

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AUTHORIZATION FORM

DESIGNATION OF SHIPPER’S REPRESENTATIVE/AGENT

Customer Name

Authorized Person

Customer Email

Phone Number

Date

Terms and conditions

By checking the box and signing, I, (Client’s name), do hereby designate and appoint through the form, (authorized person) as my true and lawful representative and agent in my name and to act on behalf as the designated “shipper” in compliance with 49 USC § 13102(13), to exercise or perform any legal act, power, duty, right or obligation whatsoever that I now have, in regard to any part of the intrastate/ interstate transportation of my household goods. Through this authorization, I grant full legal authority to my designated representative/agent to receive, sign, endorse, accept, negotiate, acknowledge, and modify any and all elements, terms, or conditions, of any and all bills of lading, estimates, warehouse receipts, contracts, waivers, other instruments in writing of whatever kind as they determine necessary in my name.

SignatureI agree to the terms and conditions

(Sign Here)

Clear Signature

TRUSTED MOVERS AUTHORIZATION FORM

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