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Authorization to Release Criminal Record
Free authorization form template for an individual to consent to the release of their criminal history record to a requesting party.
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This free authorization to release criminal record covers Requesting Party, Scope of Release, Duration, My Rights with 7 clearly marked [placeholder] fields to fill in — built for individuals and small businesses handling a straightforward legal document themselves needing a clear, professional document without commissioning custom legal drafting for a routine situation. Copy it into your own word processor, fill in the placeholders, and review it — or adapt it — before use. It's part of docstoc's free document template library, alongside business, legal, real estate, finance, and HR templates. Every template here is free to copy with no signup required, and each one carries a plain disclaimer: this is a starting point for informational purposes, not a substitute for advice from a licensed professional in your jurisdiction.
Authorization to Release Criminal Record
I, [Full Legal Name], DOB: [Date] · SSN (last 4): [XXXX], authorize [Law Enforcement Agency/Records Repository] to release my criminal history record to:
Requesting Party
Name: [Name/Organization] · Purpose: [e.g. employment background check, licensing application, volunteer screening]
Scope of Release
[ ] Complete criminal history record. [ ] Records limited to: [Specify, if applicable — e.g. felony convictions only].
Duration
This authorization is valid for [Period, e.g. 90 days] from the date signed, or for the single request described above.
My Rights
I understand I have the right to review my own record and to dispute any inaccurate information through the appropriate process before it is relied upon by the requesting party.
Signature: ______________________ Date: ____________ Printed name: ______________________
Notarization (if required): Subscribed and sworn before me this ____ day of __________, 20__. Notary Public: ______________________
*This document is provided for informational and educational purposes only and does not constitute legal advice. Many states restrict how criminal history can be used in employment decisions ("ban the box" and related laws) — an employer relying on this authorization should confirm their use of the resulting record complies with applicable law, separate from the authorization itself being valid.*
Edit directly in the box above. Download PDF anytime — the docstoc.io footer is always included and cannot be removed.
What's included
- Edit online — click the document, fill in placeholders, download a PDF
- 4 standard sections: Requesting Party, Scope of Release, Duration, My Rights
- 7 clearly marked [placeholder] fields for quick personalizing
- Free to use — no account or signup required
- Fully editable — adjust any clause to match your actual situation
- Includes a signature block, ready to print or sign digitally
- Fixed docstoc.io footer on every PDF (not removable)
Who this template is for
Freelancers & solo founders
Handling routine business paperwork without commissioning custom legal drafting for every document.
Small businesses
Standardizing recurring documents — leases, agreements, notices — across a growing operation.
Anyone reviewing before signing
Using a clear starting structure to understand what a document should cover, even if a lawyer finalizes it.
Before involving a lawyer
A solid starting draft to review with counsel, or to use directly for a low-stakes situation.
FAQ
Is this authorization to release criminal record template really free?
Yes — this Authorization to Release Criminal Record template on docstoc is free to view, edit online, and download as a PDF with no account or signup required.
What does this authorization to release criminal record cover?
This legal template includes Requesting Party, Scope of Release, Duration, My Rights. Fill in the [bracketed] placeholders, edit any clause online, then download a PDF — the docstoc.io footer stays on every export.
Is this legal advice?
No. Legal documents are exactly where a generic template is most likely to miss something that matters — the right structure, required disclosures, and even which clauses are enforceable all vary by state and situation. Use this as a starting point for a conversation with a licensed attorney, not a substitute for one.
Can I edit the wording?
Yes — edit directly on the page, adjust any section or clause, and re-fill the 7 placeholder fields to match your situation before downloading a PDF. It's a starting structure, not a rigid script.
Where can I find more free templates like this?
Browse more free legal and related document templates in the docstoc library at /document-templates/.
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- Mutual Non-Disclosure Agreement (NDA)
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Five products, one platform
Why use this instead of a generic template
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Legality
Templates are drafted for general use, not a substitute for legal advice — check the note on each page for specifics.
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Speed
Copy the subject and body directly — no form to fill in, no export step, no waiting on a download link.
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