Fill and Sign the Release Personal Form

AUTHORIZATION FOR RELEASE OF PERSONAL INFORMATION I, ______________________________________________________________________ , First Middle Last Race Sex DOB SSN am an applicant for the position of { Insert name of position applied for } with { Insert name of company }. I authorize a review and full disclosure of all records, or any part thereof, about me to any authorized personnel of { Insert name of company }, whether the records are public or private, even if the records may be otherwise considered to be privileged or confidential. I intend this authorization to be used in providing information that will be used to determine my suitability for employment with { Insert name of company }. This authorization is for the records of educational institutions; medical, psychological, and psychiatric consultation, and/or treatment; all military, selective service, and employment records; financial or credit institutions, credit reports or ratings; and criminal and/or traffic records. All information in my application for employment with { Insert name of company } is true and complete to the best of my knowledge. I understand that all of the information in the application will be investigated. Any inaccurate, untruthful or misleading statements will be a reason for immediate rejection of the application without appeal. If I need to update my application, I will send or bring the information to { Insert address }. A photocopy of this release will be valid as the original, even though the photocopy does not contain my original signature. I agree to indemnify and hold harmless { Insert name of company } and all persons from all claims, demands, causes of action, damages, losses, and expenses arising out of or because of any matter relating to this authorization. _________________________________ ______________________________ Applicant's Full Legal Signature Witness _____________________________________ _________________ Address Date _____________________________________ City, State, Zip