ABGA™ 1207 S. Bryant Blvd., Suite C, San Angelo, TX 76903| (325) 486-2242| Fax 325-486-2637 |www.ABGA.org
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ABGA Agent Authorization Form
I/We
Please print
Date
designate the following person(s) to have authority
to sign all documents on behalf of this membership.
Membership number:
Designated Agents:
Printed
Name:
Signature:
Printed
Name:
Signature:
Printed
Name:
Signature:
Printed
Name:
Signature:
Signature(s) of all persons listed on this membership:
When signing documents, agents should sign "name of membership by agent name". The signature of
one agent will be considered sufficient, unless other directions are listed in the space below.
ABGA will consider the above agent(s) authorized to sign on behalf of the membership until a revised
authorization form is received by ABGA.
Special Directions:
Question regarding this or other forms please call: (325)486-2242, fax (325)486-2637
MAIL COMPLETED FORM TO:
American Boer Goat Association
1207 S Bryant, Suite C
San Angelo, TX 76903
ABGA Agent Authorization 2014.docx
[r 9-19-2014]