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ATTACHMENT # 2 CUSTOMER REVOCATION OF AUTHORIZATION TO RELEASE INFORMATION FOR INUTILITY BUSINESS PURPOSES This form will revoke the release of previously authorized Customer Personal Information
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How to fill out customer revocation of authorization

How to fill out customer revocation of authorization
01
To fill out a customer revocation of authorization, follow these steps:
02
Begin by including the current date at the top of the form.
03
Provide the name and contact information of the customer making the revocation.
04
Clearly specify the purpose of the revocation, indicating which authorization is being revoked.
05
State the reasons for the revocation clearly and concisely.
06
Include any relevant account or authorization numbers that need to be referenced.
07
Sign and date the revocation form, ensuring the customer's signature matches their official records.
08
Provide a copy of the revocation form to the customer for their records.
09
File the original revocation form in a secure location as required by company policies and regulations.
Who needs customer revocation of authorization?
01
Any individual or entity that has previously granted authorization to another party may need a customer revocation of authorization.
02
This can include individuals revoking access to their personal information, businesses terminating agreements with service providers, or customers canceling automatic payment authorizations.
03
In general, anyone who wishes to withdraw or revoke a previously given authorization would benefit from utilizing a customer revocation of authorization.
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What is customer revocation of authorization?
Customer revocation of authorization is when a customer withdraws their permission for a company to use their personal information.
Who is required to file customer revocation of authorization?
Companies that have received authorization from customers to use their personal information are required to file customer revocation of authorization.
How to fill out customer revocation of authorization?
Customer revocation of authorization can be filled out by providing the customer's information, the specific authorization being revoked, and the reason for revocation.
What is the purpose of customer revocation of authorization?
The purpose of customer revocation of authorization is to protect the privacy rights of customers and allow them to have control over how their personal information is used.
What information must be reported on customer revocation of authorization?
The customer's information, the authorization being revoked, and the reason for revocation must be reported on customer revocation of authorization.
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