Authorization For Release Of Information

Authorization for Release of Information

Certain legal documents are required by some employers before you as an employee may be taken into their company. Most of these legal documents may be obtained from previous employers. The authorization for Release of Information is to be signed between you and your employer which may be used if you are to transfer to a different line of work or under a different company. This authorization letter allows your previous or current employer to release or disclose private, confidential, and personal information about you and/or your employment in their company.

Note that the release of any information regarding you to anyone without your written consent is illegal and is punishable by law. The authorization for release of information also secures the safety of your employers, freeing them from liability in connection to information disclosed upon consignment of the agreement.

The contract itself will include your name, social security number, date of application, and position applied for and details of who you, as an applicant wants it to be sent to. The authorization for release of information may also be used if the person who holds your records is a personal or academic reference. This gives the person the permission to hand over any legal documents requested by your employers which may include anything from employment and education and other subjects which you have to specify. Any other documents shared which have not been specified by you is considered a violation of the law. Any photocopies of this document will also be as effective as the original.

Authorization for Release of Information

Name of applicant: _________________
Social security number: ____________
Date of application: _______________
Position applied for: ______________

TO:

You are authorized to release information concerning my employment with you, or if you are a personal/academic reference, release information concerning my employment and education, including subject evaluations to ______________________.

You are further released from liability in connection with your response to this inquiry.
A photocopy of this authorization will be as effective as an original.

___________________________________________
Requester

Please send it to the following person.

________________________
Attention: _________________
____________________________
____________________________
Telephone: _________________

If there are any charges connected with this transaction, please charge:

My Credit Card Number: Expiration Date:
Exact Name on Card:

If you require a check, please contact me at the above address, by fax, email, or phone, and I will send one forthwith.

I hereby authorize the charges for this service.

____________________ Date:
Requester

Please email, fax, or phone me to confirm you have completed this transaction. Many thanks in advance for your assistance,

____________________ Date:
Requester

Authorization for Release of Information
Review List

This review list is provided to inform you about this document in question and assist you in its preparation. This general authorization for Release of Information can be more useful than some of the more specific ones offered elsewhere. This multiple part document covers the necessary elements in getting a reference, release of information, charges due thereto, and confirmation back to you as the requester.

1. Make multiple copies. Mark your calendar to send a second notice if you have not heard back in two weeks. Stay on top of this.

 

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