Common use of AUTHORIZATION TO RELEASE CONFIDENTIAL INFORMATION Clause in Contracts

AUTHORIZATION TO RELEASE CONFIDENTIAL INFORMATION. THE XXXXXXXXX XXXXXX X. XXXXXXXXX XXXXX XXXXXXXX JUVENILE JUDGE CHIEF JUVENILE PROBATION OFFICER 65th DISTRICT COURT EL PASO COUNTY EL PASO COUNTY JUVENILE PROBATION DEPARTMENT Name: Date of Birth: (PRINT NAME) Social Security Number: I authorize the release of all confidential records and information pertaining to TCIC/NCIC Records / Police / Records / Sheriff’s Records concerning myself to the 65th Judicial District Court and to the El Paso County Juvenile Probation Department. TCIC/NCIC/Police/Sheriff’s Records Signature Date EL PASO COUNTY JUVENILE PROBATION DEPARTMENT TCIC/NCIC CONTRACTOR RECORDS CHECK REQUEST REQUESTED BY: APPROVED: DIRECTOR PURPOSE: COMPLIANCE CONTRACTUAL REQUIREMENT DATE REQUESTED: Criminal Records Check Requested on: NAME DOB SSN 1.