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Get TX Request/Consent for Information from Previous Employer on Alcohol & Controlled Substances Testing 2006-2024

________ Social Security No.: ____________________________________________________ I authorize my Previous Employer, __________________________________________________________________________ at Address: ______________________________________________________________________________________________ and Phone Number: ___________________________ to release and forward information requested under 49 CFR section 382.405(f) and (h) concerning my alcohol and controlled substances testing records to: Co.

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