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AUTHORIZATION TO RELEASE INFORMATION TO LEGAL REPRESENTATIVE Sonoma County Employees Retirement Association 433 Aviation Boulevard, Suite 100, Santa Rosa, CA 95403 Tel: (707) 5658100 / Fax: (707)
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How to fill out authorization to release information

01
Obtain the correct authorization form from the organization or individual requesting the information.
02
Fill out your personal information accurately, including your full name, date of birth, and address.
03
Specify the information you are authorizing to be released and to whom it should be released.
04
Sign and date the form in the designated areas to confirm your consent.
05
If needed, have a witness sign the form to verify your authorization.
06
Submit the completed form to the appropriate party as instructed.

Who needs authorization to release information?

01
Authorization to release information is typically required by healthcare providers, insurance companies, law enforcement agencies, and other entities that may need access to your personal records or data.
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Authorization to release information is a document that allows a third party to access and share specified information about an individual.
The individual who wishes to release their information or have their information released to a third party is required to file authorization to release information.
To fill out authorization to release information, one must include their personal information, specify the information to be released, and provide details of the recipient.
The purpose of authorization to release information is to ensure that individuals have control over who can access and share their personal information.
On authorization to release information, one must report the specific information to be released, the reason for releasing it, and details of the recipient.
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