PDF_ClearanceLtrAuth - suits for damages or injuries of...

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FAMOUS LABELS 8414 W. Farm Rd Suite 180-455 Las Vegas, NV 89131 PHONE (702) 838-6893 FAX (702)-869-6661 E-MAIL [email protected] Famous Labels ___________________ ________________________________ ________________________________ Ph # ( _____ ) ______ – ________ Fax: ( _____ ) ______ – ________ Re: Application for Hire / Criminal Background History Check AUTHORIZATION FOR RELEASE OF RECORDS I, , do hereby consent to and authorize the release by Sheriff or Police Department of any and all records of arrest or convictions or other police records about me to the Personnel Office or other agent of for use in connection with my application for employment with said company. I hereby release said Police Department, their officers, agents and employees from any and all claims, actions, or
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Unformatted text preview: suits for damages or injuries of whatever nature that may result from the release of my police records pursuant to this Authorization. Applicant’s Full Name: __________________________________________________________ Address: _____________________________________________________________________ City: ________________________________ State: _________ Zip Code: ___________ Date of Birth: _____ / _____ / ______ SSN: _______ - ______ - _______ Sex: __________ Maiden Name, Aliases or Other Names Used (if applicable): ____________________________ ____________________________________________________________________________ Signature: ______________________________________________ Date: ________________...
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This note was uploaded on 10/25/2011 for the course BUS 210 210 taught by Professor N/a during the Spring '09 term at University of Phoenix.

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