DELEGATION OF AUTHORITY FORM

By the means of this letter, I …......................................................................................... born in

….......................................... on ….................................. resident in …......................................... in
…..........................................................

Document N. …..................................................... issued by on the …................................................

Home telephone …............................................................. mobile

telephone .............................................................

As a parent of …............................................................... born in ….................................................. on

…............................................................. resident in …..................................................... in
….....................................................

AUTHORIZE

Mr. /Mrs …............................................................................ born in

…............................................................ on …............................................................ resident in
…........................................................................... in …...........................................................

Document N. …....................................................................... issued by on the

…......................................................

To accompany my daughter to ….............................................................. from

…............................................. to …....................................................

Date ….............................................

Parent’s signature

Deputy’s signature
Herein:

1. Copy of the parent’s ID card;

2. Copy of the delegated person ID card;