Santa Barbara County Authorization of Agent Page 1 AUTHORIZATION OF AGENT Please fill in the following form including signatures. All signatures must be completed. If one or more of these signatures are the same, simply re-sign. Thank you. I hereby authorize the following person to act as my agent for the property located at: STREET ADDRESS_______________________________________________________ CITY, STATE, ZIP CODE: __________________________________________________ ASSESSOR'S PARCEL NUMBER: ___________________________________________ OWNER: NAME__________________________________________________________________ STREET ADDRESS_______________________________________________________ CITY, STATE, ZIP CODE: __________________________________________________ DAYTIME PHONE ________________________________________________________ PRINT NAME ____________________________________________________________ SIGNATURE ____________________________________________________________ TITLE __________________________________________________________________ (Property Owner, Partner, Corporation Officer, Specify Other) DATE __________________________________________________________________ AGENT: NAME__________________________________________________________________ FIRM NAME (IF ANY) _____________________________________________________ STREET ADDRESS_______________________________________________________ CITY, STATE, ZIP CODE___________________________________________________ DAYTIME PHONE ________________________________________________________ PRINT NAME ____________________________________________________________ SIGNATURE-AGENT______________________________________________________ DATE __________________________________________________________________ G:\GROUP\P&D\DIGITAL LIBRARY\APPLICATIONS FORMS BROCHURES PUBLIC INFORMATION\PLANNING APPLICATIONS AND FORMS\AUTHORIZATION OF AGENT FORM.DOC Created and updated by BJP070105 American LegalNet, Inc. www.FormsWorkFlow.com