Our Reference:

Client Name:     


3rd party Authorisation to Act

I hereby authorise Citizens Advice Richmond to correspond and take direction from , of  in relation to my case. This includes authorisation for all processes relating to applications, reconsiderations, appeals, disputes, negotiations and representation regarding: 

These authorities include Special Category Data, for which I authorise disclosure of:

Leave this empty:

Signature arrow sign here

Signature Certificate
Document name: 3rd Party Auth
lock iconUnique Document ID: 9460e2eddfd7d9a4961b109a6c36bb926187298d
Timestamp Audit
20th July 2021 7:42 am GMT3rd Party Auth Uploaded by Bradley Johnson - Advice@citizensadvicerichmond.org IP