Minerva, NY · Essex County
Authorization Form to Act as Agent
Property owners use this form to authorize an agent to act for them regarding a Town of Minerva permit matter.
What this form is
The Town of Minerva form lets a property owner designate an agent regarding a permit. Complete it when you want someone else to act as your agent for a permit; it asks for the premises location, tax parcel number, designated agent, permit information, date, and owner's signature for the property involved.
Who needs it
A property owner who wants to designate someone else as an agent regarding a Town of Minerva permit should complete this form.
How to submit it
Submit the completed form to the Town of Minerva Building & Code Enforcement Department, 5 Morse Memorial Hwy, P.O. Box 937, Minerva, NY 12851.
About notarization
This form is signed and dated without a notary; it contains no sworn or notarized attachment, so the signer just signs and dates it.
How to submit this form
- 1
Download The Form
Download the Town of Minerva Authorization Form to Act as Agent.
- 2
Complete The Form
Enter the premises location, tax parcel number, designated agent, and permit information.
- 3
Sign And Date
The property owner signs and dates the form; no notary is required.
- 4
Submit To The Town
Send the completed form to the Town of Minerva Building & Code Enforcement Department at the address shown.
Frequently asked questions
- What does the Authorization Form to Act as Agent do?
- It lets a property owner designate an agent regarding a Town of Minerva permit. The form records the property location, tax parcel number, agent, permit information, date, and owner's signature.
- Who completes this form?
- The property owner completes and signs the form to designate an agent regarding a permit for the premises.
- Do I need a notary for the Authorization Form to Act as Agent?
- No. This form is signed and dated without a notary, and it lists no sworn or notarized attachment.
- How do I submit the Authorization Form to Act as Agent?
- Submit it to the Town of Minerva Building & Code Enforcement Department, 5 Morse Memorial Hwy, P.O. Box 937, Minerva, NY 12851.
Need something notarized?
This Authorization Form to Act as Agent doesn’t need a notary — but if you have another Minerva form that does, a commissioned online notary can help.