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EXHIBIT 5E STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF AGING OFFICE OF THE STATE LONGER CARE OMBUDSMAN AUTHORIZATION TO RELEASE CONFIDENTIAL INFORMATION AND/OR TESTIFY
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01
Write your full name and contact information at the top of the form.
02
Provide the name of the company or organization requesting the authorization.
03
Specify the purpose for which the authorization is being granted.
04
Indicate the duration of the authorization, whether it is a one-time authorization or for a specific period.
05
Include any additional details or conditions related to the authorization.
06
Sign and date the form to validate your authorization.
Who needs exhibit 5-e - authorization?
01
Individuals or organizations granting permission for a specific purpose or activity.
02
Companies or organizations requiring authorization from individuals for legal or contractual purposes.
03
Event organizers seeking authorization from participants or attendees for certain actions or access.
Overall, exhibit 5-e - authorization is necessary for formalizing permission or consent for a particular purpose, and can be used by a variety of individuals or organizations in different contexts.
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