Dear Sir or Madam:

You are hereby authorized and directed to release to ____________ at ____________ all banking information requested by him relating to our Account No. _______________, on this one time basis only.

We would consider it a great courtesy if you would respond promptly to their inquiries.

This shall be your good and sufficient authority for doing so.
With best regards,

________________

Authorized Signer on Account

cc Inquirer listed above

Authorization for Bank to Release Information Review List

This review list is provided to inform you about this document in question and assist you in its preparation.  Sign the original and forward it to the inquirer, so they can include it with their letter seeking information about your account.  Keeping all the documents together will expedite the process.  Keep a copy of the authorization letter in your file.  The inquiry is limited to a one time one.  We advise you not give blanket inquiry rights and simply issue a new authorization should you deem it appropriate at a later date.

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