"Affidavit Granting Authority to Act (For Collection Matters)" - New York City

Affidavit Granting Authority to Act (For Collection Matters) is a legal document that was released by the New York City Department of Consumer Affairs - a government authority operating within New York City.

Form Details:

  • Released on July 12, 2017;
  • The latest edition currently provided by the New York City Department of Consumer Affairs;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the New York City Department of Consumer Affairs.

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Download "Affidavit Granting Authority to Act (For Collection Matters)" - New York City

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PAYMENT PLAN
AFFIDAVIT GRANTING AUTHORITY TO ACT
Date:
Summons and/or Fee Number(s):
.
I,
, attest, under penalty of perjury, to the following:
1) I am the owner/corporate officer/principal of
located at
. A true and accurate copy of my
government issued photo identification is attached to this affidavit.
2) I authorize
, whose
telephone number is
, and e-mail address is
,
to enter into a Payment Plan Agreement for the above Summons and/or Fee Number(s) on my
behalf or on behalf of the above business.
3) I understand that I or my business will be bound by the terms of the payment plan agreement
signed by my authorized representative.
_________________________________
Signature
Sworn before me this ___________________ day of ________________________, 20_______
________________________
NOTARY PUBLIC
Revised 07-12-17 NS
PAYMENT PLAN
AFFIDAVIT GRANTING AUTHORITY TO ACT
Date:
Summons and/or Fee Number(s):
.
I,
, attest, under penalty of perjury, to the following:
1) I am the owner/corporate officer/principal of
located at
. A true and accurate copy of my
government issued photo identification is attached to this affidavit.
2) I authorize
, whose
telephone number is
, and e-mail address is
,
to enter into a Payment Plan Agreement for the above Summons and/or Fee Number(s) on my
behalf or on behalf of the above business.
3) I understand that I or my business will be bound by the terms of the payment plan agreement
signed by my authorized representative.
_________________________________
Signature
Sworn before me this ___________________ day of ________________________, 20_______
________________________
NOTARY PUBLIC
Revised 07-12-17 NS