AUTHORIZATION TO RELEASE SCHOOL RECORDS

Date:

TO:

RE: Name of client

You are authorized to disclose to and allow and their attorneys, investigators, and representatives to examine and copy or photostat all school records relating to the above client, including but not limited to, attendance, physical education records, and scholastic records. The information disclosed will be used in connection with a legal matter for the client.

It is understood that this authorization may be voided by the client at any time. If the client does not void this authorization, it will be valid for one year from the date below.

It is understood that the client has the right to receive a copy of this authorization and a copy has been requested and received by the client.

Photostatic copies of this authorization will be considered as valid as the original.

Dated:

Signed: