Authorization Letter To Release Information

Here is a sample Authorization Letter to Release Information:

Dear [Recipient’s Name],

I, [Your Name], hereby authorize [Authorized Person’s Name] to request and receive any information related to [Reason for Request] on my behalf. This authorization includes but is not limited to [Type of Information].

I understand that the information disclosed may be protected by privacy laws and will be used solely for the purpose of [Reason for Request]. I release [Authorized Person’s Name] and any entity that provides the requested information from any liability that may arise from the disclosure of said information.

Please find enclosed a copy of my valid identification card for verification purposes.

Thank you for your prompt attention to this matter.

Sincerely,

[Your Name]