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POLYGRAPH AUTHORIZATION AND RELEASE FORM Name: Date: Time: Exam Location: My Present Address is: City: State: Zip/Postal Code: Home Phone: Work Phone: Dr. LIC.: SSN: Date of Birth: Age: Polygraph

How to fill out polygraph authorization and release

How to fill out polygraph authorization and release:

1. Start by reading the form carefully and understanding its purpose and requirements.
2. Provide your full legal name, date of birth, and contact information in the designated sections.
3. Indicate whether you give your consent for the polygraph examination and release the results to the authorized individuals or organizations.
4. If relevant, state the reason for the polygraph examination and provide any additional details requested, such as the date, time, and location of the examination.
5. Sign and date the form at the bottom, confirming that the information provided is accurate to the best of your knowledge.
6. Make a copy of the completed form for your records before submitting it to the appropriate authority.

Who needs polygraph authorization and release?

1. Individuals undergoing a polygraph examination as part of a job application process, particularly for positions that require high security or sensitive information.
2. Individuals who are involved in legal matters, such as criminal investigations or court proceedings, where a polygraph examination may be required.
3. Organizational entities, such as government agencies or private companies, that administer polygraph examinations to assess individuals' honesty, trustworthiness, or suitability for specific roles or responsibilities.

For pdfFiller’s FAQs

What is polygraph authorization and release?

Polygraph authorization and release is a form that allows an individual to authorize the release of their polygraph test results.

Who is required to file polygraph authorization and release?

Individuals who are required to take a polygraph test as part of their job application or during employment are required to file polygraph authorization and release form.

How to fill out polygraph authorization and release?

To fill out polygraph authorization and release form, the individual must provide their personal information, sign the authorization, and submit the form to the appropriate authority.

What is the purpose of polygraph authorization and release?

The purpose of polygraph authorization and release is to allow the release of the individual's polygraph test results to the relevant parties.

What information must be reported on polygraph authorization and release?

The polygraph authorization and release form typically requires information such as the individual's name, date of birth, employer's name, and the purpose of the polygraph test.

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