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A P P L I C AT I ON SERGEANT HOUSE RENTAL APPLICATION Please Print Clearly This is an important document. If you require interpretation, please call the telephone number below or come to our offices.

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How to fill out authorization to release information

01

Begin by stating your name, date of birth, and contact information at the top of the authorization form.

02

Identify the specific information that you are authorizing to be released. This may include medical records, financial information, educational records, or any other relevant documents.

03

Clearly state the name of the individual or organization that is authorized to release the information. Include their contact information if available.

04

Specify the purpose for which the information is being released. This could be for a legal proceeding, medical treatment, employment application, etc.

05

Include any special instructions or limitations regarding the release of information. For example, you may specify a specific date range within which the information can be released.

06

Sign and date the authorization form at the bottom.

07

Submit the completed form to the appropriate person or organization.

Who needs authorization to release information?

01

Authorization to release information may be required by individuals or organizations that need access to confidential information about someone else. This can include healthcare providers, legal professionals, employers, educational institutions, insurance companies, and government agencies.

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