Transfer of Responsibility/Release Form


CLIENT INFORMATION

 

AGENT INFORMATION

 I hereby appoint and authorize, listed above Representative, with their consent, to act on my behalf in my absence and make any and all required decisions concerning my move. I accept full responsibility for any and all the decisions made by my authorized representative including but not limited to: Transportation charges, Accessorial services charges, Valuation options, etc. My representative is authorized to sign any and all documents pertaining to my move. I understand that by authorizing my representative to make such decisions, the outcome of the decision made whether financial or for scheduling purposes, is my sole responsibility and that it is the responsibility of my representative to report to me of any and all changes they authorize to be made to my order.

 

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Elite Moving & Storage http://www.elitemover.com
Signature Certificate
Document name: Transfer of Responsibility/Release Form
Unique Document ID: 410fbf1eed6a15385326fba66cc0ca8e7f2e90ff
Timestamp Audit
2016-10-28 18:23:07 CDTTransfer of Responsibility/Release Form Uploaded by Elite Movers - marie@elitemover.com IP 98.212.134.224