Authorization to Obtain Employment Information

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This Authorization to Obtain Employment Information authorizes an employer to give employment history and information to an employee's attorney. This form must be signed and dated in order to be effective.

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This Authorization to Obtain Employment Information is for use by a client and gives his or her counsel authority to obtain employment information. This authorization contains all relevant information including the name of the law firm and the employer. It also sets out which employment information can be released. Many employers will not release employment history or information without an authorization.

This Authorization to Obtain Employment Information sets out the following:
  • Employer: The name and address of the client's employer;
  • Law Firm: Name of the law firm requesting the employment information;
  • Information: The reason why the information is being sought (i.e., auto accident or other injury) and information the employer is authorized to release. This authorization must be signed and dated by the client/employee.

Protect yourself and your rights by using our attorney-prepared up-to-date forms.

This attorney-prepared packet contains:
  1. General Information
  2. Authorization to Release Employment Information
State Law Compliance: This form complies with the laws of all states
Number of Pages2
DimensionsDesigned for Letter Size (8.5" x 11")
EditableYes (.doc, .wpd and .rtf)
UsageUnlimited number of prints
Product number#28064
This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.
To:     ________________________
Please be advised that the law firm of ____________________________________, represents the undersigned in an automobile accident wherein I lost income from my employment.  It will be necessary for me to obtain records from my employer showing salary, wage, bonus, commission and other relevant information.  I hereby authorize my employer to release any and all information regarding my employment and income to ___________________________ and release said employer from any and all liability associated with the release of all such information.
A photo copy of this Authorization shall have the same force and effect as the original.
Dated this ____ day of ________, 20__.
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