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REQUIREDAuthorized Person Designation/Notarized Sworn Statement Form Justice Center Criminal Background Check (CBC) Unit Fax: 5185490464Email: cbc@JusticeCenter.ny.govProvider Name: Provider Code:

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How to fill out authorized person designation form

01

Obtain the authorized person designation form from the appropriate organization or agency.

02

Fill out your personal information, including your name, contact information, and any required identification numbers.

03

Provide information about the organization or agency you are representing, including its name, address, and purpose.

04

Sign and date the form to certify that the information provided is true and accurate.

05

Submit the completed form to the designated party or authority for approval.

Who needs authorized person designation form?

01

Individuals who are acting on behalf of an organization or agency and need to be officially designated as an authorized representative.

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What is authorized person designation form?

Authorized person designation form is a document used to appoint an individual who is authorized to act on behalf of a company or organization in certain legal or business matters.

Who is required to file authorized person designation form?

Companies or organizations that need to designate an individual to act on their behalf in legal or business matters are required to file an authorized person designation form.

How to fill out authorized person designation form?

To fill out an authorized person designation form, the company or organization needs to provide the necessary information about the appointed individual, their contact details, and the specific matters they are authorized to act on.

What is the purpose of authorized person designation form?

The purpose of the authorized person designation form is to legally appoint an individual to act on behalf of a company or organization in specific matters, such as signing contracts or making decisions.

What information must be reported on authorized person designation form?

The authorized person designation form must include information about the appointed individual, their contact details, the specific matters they are authorized to act on, and any limitations on their authority.

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