ATTORNEY RELEASE
MUST BE PRINTED ON ATTORNEY’S LETTERHEAD

AUTHORIZATION FOR RELEASE OF INFORMATION 

I, ___________________________, authorize the FBI to release the results of my fingerprint search of the Criminal Justice Information Services files to my attorney: 

Attorney: 										
Address: 										

I declare, under penalty of perjury under the laws of the United States of America, that the foregoing is true and correct.  I am the person named above, and I understand that any falsification of this statement is punishable under the provisions of 18 U.S.C. Section 1001 by a fine of not more than $10,000 or by imprisonment of not more than five (5) years, or both, and that requesting or obtaining any record(s) under false pretenses is punishable under the provisions of 5 U.S.C. 522a(i)(3) by a fine of not more than $5,000. 

Your Signature: __________________________________________  Date: ________________

Attorney Signature: _______________________________________  Date: ________________