Senator Skoufis's Privacy Release Form

AUTHORIZATION FOR RELEASE OF CONFIDENTIAL INFORMATION FORM

By signing this form, I am hereby authorizing the Office of State Senator James Skoufis to discuss and or receive information, records and documentation regarding my case.

 

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By signing this form, I am hereby authorizing the Office of State Senator James Skoufis to discuss and or receive information, records and documentation regarding my case: