ST. BERNARD PARISH SHERIFF’S OFFICE
AUTHORIZATION TO RELEASE INFORMATION AND WAIVER
I voluntarily and knowingly authorize any employee, person, firm, corporation, school, government agency, its officers, employees and agents, to release any and all information concerning my former employment to any prospective employer, its officers, employees and agents, or other person or entity making a written or oral request for such information. I understand that the information disclosed may include but not necessarily be limited to:
1. Employment history, including performance evaluations, job descriptions, disciplinary reports, and any other documents contained in my personal files, including documents that may have been sealed.
2. Opinions (whether verbal or written) regarding my suitability for employment possessed by my former employer.
3. Educational or scholastic records.
4. Financial records and credit information and reports.
5. Records maintained by any law enforcement agency, including but not limited to, police reports and other records of arrest, conviction, ordinance violations, juvenile records, or those relating to traffic violations.
I understand that this information is to be used to assist the St. Bernard Parish Sheriff’s Office in determining my qualifications and fitness for the position I am seeking with the St. Bernard Parish Sheriff’s Office. I authorize the St. Bernard Parish Sheriff’s Office to obtain any information falling with the categories listed above, including any information which may be considered confidential or privileged and authorize the St. Bernard Parish Sheriff’s Office to photocopy that information if so desired.
I voluntary and knowingly fully release and discharge, absolve, indemnify and hold harmless the St. Bernard Parish Sheriff’s Office as well as any former employer, person, firm, corporation, school or government agency, its officers, employees and agents, from any and all claims, liability, demands, causes of action, damages or costs (including attorney fees), present or future, whether known or unknown, anticipated, arising from or incident to the disclosure of any facts concerning my employment and other information described above in numbers 1-5.
I further waive and release any claim whatsoever I might have for any injury occurring while competing in any portion of the examination.