Fillable RELEASE OF INFORMATION FORM (City of Stephenville)

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RELEASE OF INFORMATION FORM (City of Stephenville)

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RELEASE OF INFORMATION FORM
I, __________________________________, do hereby release any and all
information regarding my criminal history held by the Stephenville Police
Department. My identifiers are as follows:
Name ___________________________________________
Date of birth ______________________________________
Driver’s License # __________________________________
Social Security # ___________________________________
_________________________
REQUESTER
If you are not making this request in person, you MUST sign it in front of a
Notary.
Sworn to and subscribed before me this ___ day of ___________, 2___.
____________________
NOTARY PUBLIC
IT IS OUR DEPARTMENT POLICY TO ONLY PERFORM BACKGROUND CHECKS ON
INDIVIDUALS WITH THEIR CONSENT.
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RELEASE OF INFORMATION FORM (City of Stephenville)

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Completed 24 January 2021

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