Authorization for Release of Information.
I hereby authorize a review of and full disclosure of my personal and professional background including credit, criminal, driving and service records to any duly authorized agent of the Island County Emergency Services Communications Center, whether the said records are of a public, private or confidential nature.
The intent of this authorization is to give my voluntary consent for full and complete disclosure of information and records regarding my character, general reputation, credit, previous employment, and similar background information and to contact any and all references from any or all of the following sources:
• Any educational institution.
• Any business, public utility, financial or credit institution to obtain financial statements, records of loans, credit reports or ratings, or other records.
• Any office, clinic, sanitarium, hospital or private practitioner where illnesses, injuries and/or deterioration (physical and/or mental in nature) are diagnosed and treated.
• Military records including the U.S. Veteran's Administration and Selective Service System.
• Employment, past employment and pre-employment records including background reports, efficiency ratings, complaints or grievances filed by or against me.
• Records and recollections of attorneys at law, or of 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.
• Any public or private social service agency.
• Friends, relatives and neighbors.
• Observations from Supervisory personnel.
• Social media networks as listed (platforms)
I understand that any information obtained by a personal history background investigation, which is developed directly or indirectly, in whole or in part, upon this release authorization will be considered in determining my suitability for or continuance of employment by
the Island County Emergency Services Communications Center.
In consideration for being reviewed for valuable employment desired by me, I hereby release any individual or institution, including its agents, officers, employees or related personnel, both individually and collectively, from any and all claims, liability and damages of whatever kind, which may arise out of furnishing such information and which may at any time result in me, my family, heirs or associates because of compliance with this authorization and request to release information or any attempt to comply with it.
If employed by ICOM, in consideration for assisting me in providing information to prospective employers at no cost to me.
I release ICOM from any liability for future references it may provide regarding my work history at the agency.