Authorization to Release Information for Potential Employers

for Your State

Employee Authorization to Release Information to a new potential employer.

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Typically, potential employers will want to check the truthfulness and validity of the assertions made by a candidate on a resume or job application. For example, a potential employer may want to be assured that the candidate had not been fired from a previous position or that his educational credentials were in fact earned by him. However, past and present employers and schools may be hesitant to release this information for fear of violating the candidate's privacy. To combat this, a potential employer can use an Authorization to Release Information. This release is signed by the candidate when he applies for a position and expressly allows past and present employers and schools to release information to the employer regarding such things as performance evaluations, work-related characteristics and termination records.

This form can be used in all states.

This package contains: (1) Instructions and Checklist for the Authorization to Release Information (the "AuthorizationÉĚ); (2) Information regarding the Authorization; (3) the Authorization.
Number of Pages3
DimensionsDesigned for Letter Size (8.5" x 11")
EditableYes (.doc, .wpd and .rtf)
UsageUnlimited number of prints
Product number#20479
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.
 
 
Authorization to Release Information

 

 
   I hereby authorize ____________________________________ [insert name of potential employer] to make any investigations of my prior employment or educational history.  This information will assist them in their assessment of my qualifications.
 
   I hereby authorize my present and past employers and schools that I have attended to release any employment information (including attendance records, performance evaluations, etc), references, academic records (including transcripts, credentials, etc.) and any other confidential information that _______________________________ [insert name of potential employer] may request.  
 
   I hereby waive any right I may have to review the information collected through the above authorization.  
 
   I have carefully read and reviewed all the provisions above and have voluntarily agreed to sign this authorization.
 
 
 
 
 
Date: ___________________________________
 
__________________________________________
(Signature of Candidate)
 
__________________________________________
(Printed Name of Candidate)

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