INFINITE

CHAMPIONS
FORM 008

AUTHORIZATION LETTER

Date: _______________________

To Whom It May Concern:

I _________________________________, with B.A. # ____________, ___________,

____________, and _____________ hereby authorize Mr. / Ms. ________________________,
with B.A. # __________ to claim my First Vita Plus Check/s, SCQ, SOC Stub on my behalf.

Thank you and Good Vita Morning! POWER!

Respectfully yours,
_________________________
Signature over printed name
Representative:
_________________________
Signature over printed name

Please attach 2 Identification of both parties***