Release Form | Lifetime Moving & Storage

Release Form/Transfer of Responsibility Form

Release Form

Customer Name

Customer's Phone

Email on file

Representative Name

Representative's Phone

Check Box and Initial

I hereby appoint and authorize, listed above Representative, with their consent, to act on my behalf in my absence and make any and all required decisions concerning my move. I accept full responsibility for any and all the decisions made by my authorized representative including but not limited to: Transportation charges, Accessorial services charges, Valuation options, etc. My representative is authorized to sign any and all documents pertaining to my move. I understand that by authorizing my representative to make such decisions, the outcome of the decision made whether financial or for scheduling purposes, is my sole responsibility and that it is the responsibility of my representative to report to me of any and all changes they authorize to be made to my order.

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