[Your Name]

[Street Address]

[City, ST ZIP Code]

[Date]

[Recipient Name]

[Title]

[Company Name]

[Street Address]

[City, ST ZIP Code]

Dear [Recipient Name]:

This letter is to inform you that I give permission to [Name] of [Company Name] to authorize work done in my name at my home ([Street Address], [City, ST ZIP Code]) up to the amount of $[maximum amount]. I agree to be responsible for payment of all bills related to such work up to but not exceeding the amount specified above. Please contact me directly at [phone number] for authorization of work that exceeds the amount specified above.

Sincerely,

[Your Name]

[Your account number]