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COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE Childlike and Abuse Registry P.O. BOX 8170 HARRISBURG, PENNSYLVANIA 171058170CONSENT/RELEASE OF INFORMATION AUTHORIZATION FORM FOR THE PENNSYLVANIA

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The 'I hereby authorize form' is a document that gives permission for a specific action or request.

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Individuals or entities who need authorization for a particular task or transaction.

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The form typically requires the individual's or entity's name, signature, date, and specific authorization details.

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The purpose of the form is to grant permission or approval for a specific action.

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The form may require details about the authorized task, duration, and any special conditions.