I do hereby authorize a review and full disclosure of all records, or any part thereof, concerning myself to any duly authorized agent of the Madison County Sheriff s Office, or any agency assisting them, whether the said records are public or private, and including those which may be deemed to be a privileged or confidential nature. The intention of this authorization is to provide information which will be utilized for investigative resource material.
I authorize the full and complete disclosure of the records of educational institutions; financial or credit institutions; commercial or retail mercantile establishments and retail credit agencies; results of polygraph examinations, efficiency ratings, complaints or grievances filed by or against me; records of complaints of a civil nature made by or against me and including but not limited to the records and recollections of attorneys at law, or other counsel representing or having represented me; and any records of any type whatsoever which concern any criminal charges involving me.
I further authorize the release of information concerning all of the above mentioned areas, or any other information which has a bearing on my fitness or ability to become an employee of the Madison County Sheriff s Office, even though such information is not contained in written records and regardless of whether such information is considered privileged or confidential in nature.
A photocopy of this release form will be valid as an original hereof, even though the said photocopy does not contain an original writing of my signature.