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Get and Sign Authorized Users Signature Log Department of 2019-2022 Form

Get and Sign Authorized Users Signature Log Department of 2019-2022 Form

Use a signature log template 2019 template to make your document workflow more streamlined.

____________________________________________ DEA# ________________________________ Date Signed Name Please print Job Title Signature Initials As used in CS records Date Departed I hereby certify that I have designated the persons listed above as Authorized Users for this location. Person is no longer an Authorized User when a “Date Departed” is entered. Whenever this form is updated, be sure to forward a copy to your supplier(s) so they are aware of who can/cannot pick up controlled...
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