Third Party Authorization Letter
TO WHOM IT MAY CONCERN,
Please note the following information in your system:
I hereby appoint Falcon Roofing and its successors and or assignees to discuss any and all matters concerning my aforementioned claim. Falcon Roofing and its successors and or assignees are authorized to work with my Insurance Company, and to receive and inspect any and all information regarding my claim documents you have on record. I also request you send all claim documents to the designated agent. I understand that I am solely responsible to review all information sent by my Insurance Company to Falcon Roofing and its assignees concerning my payment request.
Designated Agent: Steve Darakhshan
P: (855) 409-ROOFE: firstname.lastname@example.org
Leave this empty:
Your legal name
Your email address
Signed by Steve Darakhshan
Signed On: August 13, 2021
If you have questions about the contents of this document, you can email the document owner.
Document Name: Third Party Authorization Letter
Agree & Sign