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AUTHORIZATION FOR RELEASE OF INFORMATION FOR
TENANT SCREENING PURPOSES Authorization and Release: I authorize the complete release of these records or data pertaining to me which an individual, company, firm, corporation, or public agency may have. I hereby release Global Tenant Screening, LLC, National Employment Screening LLC, and its agents, affiliated companies, officials, representatives, or assigned agencies, including officers, employees, or related personnel both individually and collectively, from any and all liability for damages of whatever kind, which may at any time, result to me, my heirs, family or associates because of compliance with this authorization and request to relapse. I certify that all information provided below and on my application is correct to the best of my knowledge. Any false statements provided in this form and my application will be considered just cause for disqualification at any time. This authorization and consent shall be valid in original, fax, or copy form. The following information is required by law enforcement agencies and other entities for identification purposes when checking records. It is confidential and will not be used for any other purpose. Applicant’s Signature Maiden/AKA/Previous Name(s X_______________________________________
_______/________/20_______ ________/________/19______Date of Birth ____________________________Driver License Number State ____________________________________Current Address (______)___________________Home Phone (_____)_____________Work
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