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Entry #54361
Proxy Request
Submitted: 2026-02-28 00:36:16
Form Fields
Your Name
ID: 8
First: Isaac
Last: Means
Your vNumber
ID: 5
V00411789
Email
ID: 17
Email address of person you are authorizing to check items out
ID: 7
Name of the person you are authorizing
ID: 9
First: Amy
Last: Bowden
When should the authorization should expire?
ID: 12
03/31/2026
Consent
ID: 14
Consent: 1
Text: I understand and agree to the above
Description: 8