Here is an Authorization Form Template that you can use and modify at your discretion for your business. This authorization form can be used as an agreement between you and your customer(s).

Authorization Form (PDF Format)
Authorization Form (Doc Format)

Disclaimer: This sample is provided for general informational purposes and may not reflect the current law(s) in your jurisdiction. We are not providing legal advice and we strongly encourage you to solicit legal advice for any contractual relationship with your current or prospective customers or clients.