DIY Legal Forms

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Authorisation To Release Information



Please be advised that I have applied for a position with [Company]. I have been requested to provide information for their use in reviewing my background and qualifications.

Therefore, I authorize the investigation of my past and present health, character, education, military and employment qualifications.

The release in any manner of all information by you is hereby authorised whether such information is of record or not, and I do hereby release all persons, agencies or firms from any liabilities resulting from providing such information.

This authorisation is valid for [--] days from the date of my signature below. Please keep this copy of my release request for your files.

We thank you for your cooperation.


[Your Name]

[Your Title]

[Your Telephone Number]

Witnessed by: