Free Authorization to Obtain Employment Information

This Authorization to Obtain Employment Information is given by a client to an attorney in order to obtain information regarding client’s employment. This authorization sets forth the specific information which can be given including amounts paid to employee under a sick leave policy and other financial benefits. This Authorization to Obtain Employment Information is valid for one year from the date of signing.

Disclaimer:This was not drafted by an attorney & should not be used as a legal document.


I, _________________________________ of ___________________________________________ ______________________________________________________________ , the undersigned, hereby authorize _______________________________________________________ , and any other firm or person by whom I am or I have been employed (the “Employer”), to give to the law office of ____________________________________________________ (“Law Firm”) any and all information in their possession regarding my employment, job title, nature of work, hours and time lost from work before and after the accident or occurrence of ______________________________________.
I further authorize the Employer to release all information related to amounts paid or due under any sick leave plan, wage continuation plan or group hospital or accident benefit plan, including the financial benefits received by me.
I agree that this authorization shall remain valid for one year from the date signed.

Dated this ______ day of ______________________, 20___.

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