Can the list be signed electronically?

Yes. Electronic signatures are valid under the ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted, provided intent, consent, attribution, and record retention are met. Confirm the relying party accepts e-signed copies and whether a consumer disclosure is required.

Do banks require notarization?

Requirements vary by bank and state. Some banks accept e-signed lists with proper authentication; others require notarized signatures or corporate resolutions. Always verify the bank’s acceptance policy before submitting.

How do I revoke an authorization?

Record revocations in writing, date and sign them, and distribute to all recipients. Update the master list and retain the revocation. Note that some third parties may require separate notification procedures.

What if a name changes after signing?

Execute an amendment with the new legal name, include proof of name change, and circulate the updated list. Maintain the prior signed version for records and link the amendment to it.

Are witnesses required?

Witness requirements depend on state law and the relying party. For certain documents and jurisdictions (e.g., Florida deeds) two witnesses are required; check state rules and recipient policies.

How should I store completed lists securely?

Keep signed originals and electronic copies in encrypted storage with access controls. For healthcare, follow HIPAA retention rules (45 CFR §164.530(j)); for tax-related matters, retain records per IRC §6501(a).

Electronic Signature
Templates
Miscellaneous
Authorized Persons List Template

Authorized Persons List Template

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

AUTHORIZED PERSONS LIST TEMPLATE AND AUTHORIZATION AGREEMENT

Client Name: Company Name:

Effective Date: ,

WHEREAS

WHEREAS, Client Name: desires to designate one or more authorized persons to act on its behalf in specified matters; and

WHEREAS, Company Name: is willing to rely on a written list of authorized persons subject to the terms of this Agreement;

NOW, THEREFORE, in consideration of the mutual covenants set forth herein, the parties agree as follows:

SCOPE OF WORK

Describe the general services, interactions, or transactions for which listed authorized persons may act. Include limits on monetary amounts, document types, and other material constraints.

AUTHORIZED PERSONS LIST

The following persons are authorized, within the scope described above and subject to any limitations noted below, to act on behalf of Client Name for matters relating to the Scope of Work. Client must promptly provide written notice of any additions, modifications or revocations.

Authorized Person 1 — Full Legal Name: Job Title / Relationship: Scope of Authority (describe specific rights): Contact Information:

Effective From:

Authorized Actions (check all that apply): Sign contracts Approve payments up to specified limit Access confidential records Other:

Active (if unchecked, this entry is considered revoked)

Authorized Person 2 — Full Legal Name: Job Title / Relationship: Scope of Authority (describe specific rights): Contact Information:

Effective From:

Authorized Actions (check all that apply): Sign contracts Approve payments up to specified limit Access confidential records Other:

Active (if unchecked, this entry is considered revoked)

Authorized Person 3 — Full Legal Name: Job Title / Relationship: Scope of Authority (describe specific rights): Contact Information:

Effective From:

Authorized Actions (check all that apply): Sign contracts Approve payments up to specified limit Access confidential records Other:

Active (if unchecked, this entry is considered revoked)

PAYMENT TERMS

Payment Amount: Payment Schedule (describe dates, milestones, or invoicing terms): Late Fee / Interest on Overdue Amounts:

TERM AND TERMINATION

Term Start Date:

Term End Date:

Notice Period for Termination (number of days):

Termination for Cause: Either party may terminate this Agreement immediately upon written notice if the other party materially breaches a provision of this Agreement and fails to cure such breach within the notice period specified above. Termination does not relieve either party of obligations incurred prior to termination.

CONFIDENTIALITY

Each party shall maintain the confidentiality of non-public information disclosed in connection with this Agreement. Authorized persons shall be permitted to access confidential information only to the extent necessary to perform their authorized duties and shall be bound by confidentiality obligations at least as restrictive as those set forth herein. Disclosure required by law shall be made only after reasonable notice to the disclosing party and, where practicable, opportunity to seek protective relief.

GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the state of without regard to conflict of laws principles.

ENTIRE AGREEMENT

This Agreement, including the Authorized Persons List attached hereto, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous understandings, agreements, and communications, whether written or oral.

CERTIFICATION

The undersigned certifies that the persons listed on this Authorized Persons List are accurately identified, hold the stated positions, and are authorized to perform the actions checked during the period indicated. Client agrees to notify the Company promptly in writing of any changes.

I certify that the information provided in this Authorized Persons List is true and correct.

Client Name:

By:

Date:

Company Name:

By:

Date:

What an Authorized Persons List Template Is

An Authorized Persons List Template is a standardized form that identifies individuals granted authority to act on behalf of an organization or account. It records names, roles, contact details, scope of authority, effective dates, and signature blocks so third parties can verify who may request transactions, receive information, or authorize access under corporate, financial, property, or patient-related workflows.

Why maintaining a clear authorized persons list matters

A concise authorized persons list reduces processing delays, prevents unauthorized access, and creates an auditable record that supports regulatory compliance and internal control.

Who typically completes an Authorized Persons List

The template helps HR, legal, finance, and operations teams enforce role-based permissions and maintain a single source of truth for authorized signers.

Corporate administrators responsible for vendor payments, signatory authority, and bank relationships.
Healthcare practice managers controlling who may receive protected health information or approve patient-related actions.
Property managers and real estate agents authorizing key access, lease signings, and maintenance approvals.

Step-by-step: filling and issuing the Authorized Persons List

A clear sequence reduces errors and ensures the list is accepted by banks, vendors, and internal stakeholders.

01

Prepare form: Choose the correct template and review company policies.
02

List individuals: Enter full names, roles, contact details, and limits of authority.
03

Signatures: Collect signatures from authorized approvers and each listed person.
04

Distribute and file: Send to affected vendors, banks, and retain a secure copy.

Core components to include in a professional template

Ensure the template contains the elements below so relying parties can verify authority reliably and consistently.

Header information

Document title, company legal name, company EIN or registration number, and a unique document ID to allow traceability and record linking.

Authorized person details

Full legal name, job title, business address, business phone and email for each person authorized to act on behalf of the organization.

Authority description

Clear, itemized description of permitted actions (sign contracts, access accounts, request records), including monetary limits or project scope.

Effective timeframe

Explicit effective date and expiration or 'until revoked' clause so relying parties know when authority begins and ends.

Approval and signature lines

Designated approver signature, printed name, title, date, and witness or notary blocks where required by third parties.

Revision and revocation section

Space to record amendments, revocations, or a version history so auditors can verify which list applied at any given time.

Essential data elements for verification

Person Name: Exact legal name

Title: Role or job title

Contact: Phone and business email

Authority Scope: Authorized actions

Effective Date: MM/DD/YYYY

Signature: Signed and dated

How to customize and complete the template online

Configure a digital workflow so the list can be completed, signed, and distributed without printing.

Field	Configuration
Name and role fields	Mandatory, text validation
Date fields	Use MM/DD/YYYY format enforcement
Signature field	Require signer name attribution and timestamp
Reviewer step	Add approver with conditional routing

Digital signing and delivery considerations

Ensure the chosen platform can produce a certificate of completion and meets any industry compliance requirements before submitting the list to third parties.

File formats: PDF, DOCX supported
Authentication: Email, SMS, or stronger
Integrations: CRM and storage systems

Typical eSignature vendor pricing and capabilities for this template

Compare baseline costs and compliance features when choosing an eSignature provider for high-volume or regulated Authorized Persons Lists.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	No	No	Yes, limited	Yes, limited
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Common mistakes to avoid

Using nicknames instead of legal names, which blocks verification.
Leaving scope vague, creating disputes about permitted actions.
Failing to include effective or end dates, causing authority gaps.
Not recording revocations or amendments, leading to conflicting lists.

Consequences of incorrect or outdated lists

Financial loss: Unauthorized transactions

Regulatory exposure: Compliance violations

Contract disputes: Invalidated actions

Operational delays: Returned or rejected requests

Reputational harm: Loss of vendor trust

Audit findings: Documentation deficiencies

Where to send and how submissions are processed

Determine the list recipients and follow the recipient’s preferred verification process to avoid rejections.

Internal filing: Store signed original in secure records
Banks and vendors: Send notarized or e-signed copy per bank policy
Regulatory bodies: File with agency only when required
Third-party services: Provide signed list to payroll, benefits, or escrow agents

Real-world examples of the template in use

These examples show how organizations applied an authorized persons list in common scenarios.

Martin Properties — Property Management

A small property manager standardized an authorized persons list for agents and contractors to streamline lease signatures and maintenance approvals.

The list included role-based scopes and expiry dates.
The standardized form reduced on-site delays and ensured escrow agents accepted digital copies for lease closings.

Fertility Centers of Illinois — Healthcare

A clinic created a detailed list for staff authorized to receive patient records and sign release forms.

It paired the list with a BAA for vendors.
The combined documentation clarified access rights during audits and supported HIPAA-required access controls.

Practical tips to ensure acceptance and clarity

Follow these best practices to help relying parties accept the list and reduce follow-up requests.

Use full legal names consistently

Match names exactly to government-issued IDs and corporate records to avoid identity verification failures during bank or vendor checks.

Define authority precisely

List permitted actions and monetary thresholds to limit ambiguity; specify excluded actions when necessary to prevent misuse.

Record version history

Include amendment dates and approver signatures so auditors can trace which list applied at any moment in time.

Confirm recipient requirements

Ask banks and vendors whether they require notarization, witnesses, or a corporate resolution before submitting to prevent rejections.

Frequently asked questions and troubleshooting

Answers to common questions about using and validating an Authorized Persons List Template.

Need help? Contact support

Can the list be signed electronically?
Yes. Electronic signatures are valid under the ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted, provided intent, consent, attribution, and record retention are met. Confirm the relying party accepts e-signed copies and whether a consumer disclosure is required.
Do banks require notarization?
Requirements vary by bank and state. Some banks accept e-signed lists with proper authentication; others require notarized signatures or corporate resolutions. Always verify the bank’s acceptance policy before submitting.
How do I revoke an authorization?
Record revocations in writing, date and sign them, and distribute to all recipients. Update the master list and retain the revocation. Note that some third parties may require separate notification procedures.
What if a name changes after signing?
Execute an amendment with the new legal name, include proof of name change, and circulate the updated list. Maintain the prior signed version for records and link the amendment to it.
Are witnesses required?
Witness requirements depend on state law and the relying party. For certain documents and jurisdictions (e.g., Florida deeds) two witnesses are required; check state rules and recipient policies.
How should I store completed lists securely?
Keep signed originals and electronic copies in encrypted storage with access controls. For healthcare, follow HIPAA retention rules (45 CFR §164.530(j)); for tax-related matters, retain records per IRC §6501(a).

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