Authorized Signatory Designation Form

This form must be completed to designate company Authorized Signatory. You are allowed to designate up to three Authorized Signatories per company.

Section 1: Company Information

Company Name*

Company Representative Name:*

First Name

Last Name

Company Representative Title*

Email*

Phone*

Pursuant to requirements of Federal Regulations and the Des Moines International Airport Security Program, the following individuals are designated as the responsible person(s) to request Airport Identification Cards, Vehicle Permits, and access keys.

This form must be completed to designate company Authorized Signatory. You are allowed to designate up to three Authorized Signatories per company.

Section 1: Company Information

Section 2: Authorized Signatory Designation