When you want to decline an authorization given earlier, you can use this No Authorization Letter sample template to communicate to all involved parties.
[Sender’s Name]
[City, State and Zip Code]
[Mobile NNumber]
[Date]
[Recipient’s Name]
[City, State and Zip Code]
[Mobile Number]
To Whom It May Concern,
I hereby withdraw authorization for [Matter previously Authorized] that was consented on [Date] between [Parties Involved]. The required services have been delivered as required, and the need for authorization is no longer applicable.
Please find attached documentation and proof of identity to effect this process. Thank you for your assistance in this matter. For any clarification, reach out to me through my mobile number [Number].
Sincerely,
[Sender’s Signature]
[Sender’s Name]
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