Would this help?
Reference is made to the conversation held on [date field] between [drop down menu containing titles of person’s positions to choose from. Example: Chief] [Text box to enter the full name of the person] and this writer, in which[drop down menu containing titles of person’s position] [Text box to enter the name of the person]authorized….
It would read something like this… “Reference is made to the conversation held on [06/19/19] between [Chief] [Robert Smith] and this writer, in which [Chief] [Robert Smith] authorized….”
I placed the brackets around the date field, drop down menu and text box.