You are on page 1of 1

Date : Date

Attention : Pru Life UK


From : Name of Client
PN: Policy Number
Subject : Authorization to Receive Refund Check

This is to authorize NAME OF AUTHORIZED PERSON to receive my refund check for


PN: XXXXXXXX. Attached are photocopies of our IDs for your reference.

Thank you.

Regards,

Client Name & Signature

You might also like