Click or tap here to enter text.

Delegated Authority form

Delegator Name Click or tap here to enter text.

information
Position Click or tap here to enter text.

Institution Click or tap here to enter text.

Email Click or tap here to enter text.

Telephone Click or tap here to enter text.

Type of request ☐ Add delegation (complete Sections II and V only)

Select one of the ☐ Revoke delegation (complete Sections III and V only)
options
☐ Change delegation (complete Sections IV and V only)
☐ Add, revoke or make changes to a sub-delegation (also complete section V)

II. Add New Name of Delegatee Click or tap here to enter text.
Delegation
Position Click or tap here to enter text.
Delegated powers
Institution Click or tap here to enter text.
Please list all
delegations and Effective date of Click or tap to enter a date. Expiration date Click or tap here to
reference where delegation of delegation enter text.
appropriate the
relevant section of
the Financial
Delegated powers and authority Scope and limitations Sub-
Regulations delegations
e.g. Authority to Sign Contracts e.g. GBP limits, dual signatures,
(Fin Regs 2012,subsection 6) approvals required allowed-Y/N?
Sub-delegations
An additional form Click or tap here to enter text. Click or tap here to enter text. Choose an
must be completed item.
for any sub-
delegations and Click or tap here to enter text. Click or tap here to enter text. Choose an
approval of HOI item.
obtained

Click or tap here to enter text. Click or tap here to enter text. Choose an
item.

III. Revoke Existing Name of Delegatee Click or tap here to enter text.
Delegation
Enter the details for Position Click or tap here to enter text.
individual to whom
Institution Click or tap here to enter text.
the delegation was
made. Effective date of Click or tap to enter a date.
revocation

Description of Click or tap here to enter text.

delegation to be
revoked

Finance Division Version 1.0 Page 1 of 2

 Click or tap here to enter text. Delegated Authority form

IV. Change scope of Name of Click or tap here to enter text.

existing delegation Delegatee

Position Click or tap here to enter text.

Institution Click or tap here to enter text.

Effective date Click or tap to enter a date.

of change

Existing Click or tap here to enter text.

delegation

Click or tap here to enter text.

Required
change

V. Signatures Delegator signature

Must always be Date Click or tap to enter a date.
completed

By signing below, I accept full responsibility for the delegation of authority granted herein and agree to
Complete when comply with the limitations on such authority and the University of Cambridge Financial Regulations.
adding new or Any misuse of delegated authority by me may result in disciplinary action.
changing existing
delegations Delegatee signature

Name Click or tap here to enter text.

Date Click or tap to enter a date.

Complete when I understand that the delegation authority previously granted has now been revoked as detailed above.
revoking Any misuse of delegated authority by me may result in disciplinary action.
delegations Previous Delegatee
signature

Name Click or tap here to enter text.

Date Click or tap to enter a date.

VI Approval of sub- Approver title Click or tap here to enter text.

delegations
The HOI must Signature
approve all new
Name Click or tap here to enter text.
sub-delegations
and any changes to Date Click or tap to enter a date.
or revocations of
existing
arrangements.

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