To Whom It May Concern: 

I, (state first-party’s name), do hereby authorize (name of authorized representative), to claim and receive my NBI Clearance on (release date of the document) on my behalf due to (insert reason for absence).

The representative will show to you (name of 2 valid IDs you will provide) as proof of my consent. Accompanying my valid IDs is the (insert the valid ID of the bearer) of the bearer for identification purposes.

For any concerns and questions about this transaction, you may contact me at (insert phone number).

Thank you very much and looking forward to your consideration.