Release Of Information For Social Security Administration In Clark

State:
Multi-State
County:
Clark
Control #:
US-00458
Format:
Word; 
Rich Text
Instant download

Description

The releasor authorizes his/her employer to release employment references including, but limited to, his/her employment history and wages and any information which may be requested relative to his/her employment, employment applications, and other related matters, and to furnish copies of any and all records which the employer may have regarding his/her employment.

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Please complete these fields in case we need to contact you about the consent form). TO: Social Security Administration.This section exhibits the Clark Court Order Informational Notice we are mailing to title II and title XVI class members. Clark County Social Services is here to support you. Call us at for information on available resources. You may also call toll free 1-, or for the deaf or hard of hearing call the TTY number 1-, or contact your local Social Security office. Don't forget to write down the application number for both the SSA-16 and the SSA i3368. Choose "2" Debt Resolution from the Debt Management Menu (DMMU). To complete this form: • Fill in the name, date of birth, and Social Security Number of the person to whom the information applies. Kimberly-Clark (NYSE: KMB) and its trusted brands are an indispensable part of life for people in more than 175 countries.

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Release Of Information For Social Security Administration In Clark