AUHTORIZATION TO RELEASE INFORMATION
TO WHOM IT MAY CONCERN:
I, __________________________________, do hereby authorize any Police Officer of the City of
Tuskegee or any other authorized representative bearing this release, within one year of this date, to obtain
any information or records from your files pertaining to my employment, military and educational records. I
further state that I will not hold you, your firm, or its officers liable for release of this information.
CITY OF TUSKEGEE, ALABAMA
______________________________________
Signature of Applicant
_________________________
Social Security
________________________________________
Signature of Person Receiving Information
Date