Authorization for Criminal Records Verification

I hereby authorize River of Grass Unitarian Universalist Congregation to request from First Advantage National Criminal File Search information regarding any record of charges or convictions contained in its files or in any criminal file maintained on me, whether said file is a local, state, or national file, and including but not limited to accusations and convictions for crimes committed against minors, to the fullest extent permitted by state and federal law. I do release said entity from all liability that may result from such disclosure made in response to this request.

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Name *

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Current Phone Number: *

Social Security Number: *

Date of Birth: *

Complete Current Address: *

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City

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Do you authorize River of Grass to run a Criminal Records Verification? *

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Authorization for Criminal Records Verification​

Authorization for Criminal Records Verification