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OFFICE OF THE UNIVERSITY REGISTRAR 118 College Drive #5006 | Hattiesburg, MS 39406001 Phone: 601.266.5006 | Fax: 601.266.5816 | www.usm.eduCONSENT TO RELEASE of STUDENT INFORMATION NAME OF STUDENT

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How to fill out consent to release of

01

Obtain a copy of the consent to release form from the appropriate party or organization.

02

Fill in your personal information such as name, date of birth, address, and contact information.

03

Identify the specific information that you are authorizing to be released.

04

Sign and date the form in the designated areas.

05

If needed, have a witness sign the form as well.

06

Submit the completed form to the necessary party or organization.

Who needs consent to release of?

01

Anyone who wishes to authorize the release of their personal information to a third party.

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What is consent to release of?

Consent to release of is a legal document that allows an individual or organization to share a person's private information with a third party.

Who is required to file consent to release of?

Any person or organization that wishes to disclose an individual's information to a third party is required to file consent to release of.

How to fill out consent to release of?

Consent to release of can be filled out by providing the necessary personal information of the individual whose information is being released, specifying the information to be disclosed, and signing the document.

What is the purpose of consent to release of?

The purpose of consent to release of is to protect an individual's privacy by ensuring that their personal information is only shared with authorized parties.

What information must be reported on consent to release of?

The information that must be reported on consent to release of includes the individual's name, contact information, the specific information to be disclosed, and the recipient of the information.

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