LETTER OF PERMISSION TO WIRE

TENANT NAME:

OWNER NAME:

SERVICE ADDRESS:

CABLE COMPANY:

I HEREBY GRANT PERMISSION TO INSTALL CABLE TELEVISION EXTERNAL

WIRING ON THE STRUCTURE LISTED AT THE ABOVE ADDRESS.

I FURTHER STATE THAT I AM THE PROPERTY OWNER AND/OR THE PERSON

AUTHORIZED BY P.O.A. MANAGEMENT TO APPROVE SUCH WORK ON THE
STRUCTURE LISTED AT THE ABOVE SERVICE ADDRESS.

AUTHORIZED SIGNATURE:

DATE:

Please provide a signed copy to the cable office prior to installation date or have available for the
installer on the date of installation. Should you have any questions, please contact 1-800-903-0508.