This document must be signed and notarized (with a stamp). Print out this form so you can have it notarized.(attach additional address if needed). This is to certify that I,. (property owner name), am the owner of the property located at: ,. Please provide information about the main person we can contact about this authorization. This is a general description of powers of attorney under Utah law. It is not meant to answer all possible questions concerning powers of attorney. To act on my behalf, take all actions necessary to represent my interest in the above named property, and be my. You will need an Adobe Acrobat to view, fill out, or print the PDF forms. Please note that Intermountain Healthcare is unable to change health information in a document but can create an amendment to the record.

Authorization Letter With Address In Utah

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