Maypearl PD Release form

Agreement – Not to sue, Authorization for Release of Personal Information

This form is a mandatory document required for all prospective police officer employees. This form grants the Maypearl Police Department authorization to conduct a complete and thorough background investigation, which is a critical step in the hiring process. All applicants must fully complete and submit this signed Release Form in addition to their standard Employee Application to be considered for employment.

Know all men by these presents:

I do hereby authorize a review of and full disclosure of all records concerning myself and any duly authorized agent of the City of Maypearl Police Department, whether the said records are of a public, private, or confidential nature.

The intent of this authorization is to give my consent for full and complete disclosure of the records of educational institutions; financial or credit institutions, including records of loans; medical and psychiatric treatment and/or consultation, including hospitals, clinics, private practitioners, and the US Veterans Administration; employment and pre-employment records, including background reports, efficiency ratings, complaints or grievances filed by or against me; and the records and reconciliations of attorneys at law, or other counsel, whether representing me or another person in any case, either criminal or civil, in which I presently have, or have had an interest.

I understand that any information obtained by a personal history background investigation which is developed directly or indirectly, in whole or part, upon this release authorization will be considered in determining my suitability for employment by the City of Maypearl. I also certify that any person(s) from any and all liability which may be incurred as a result of furnishing such information.

A photocopy of this release form will be valid as an original thereof, even though said photocopy does not contain an original writing of my signature.