Authorization to Release Information I authorize Provide Care, Inc. to investigate my current or previous employment and academic experience/qualifications. I authorize the release to Provide Care, Inc. of any information from my personnel file concerning my job performance, reputation, and character that is pertinent to my potential employment. This includes but is not limited to: written employee evaluations conducted prior to my separation of employment and my written responses, written disciplinary warnings and actions in the 5 years prior to the date of this authorization and my written responses, and written reasons for my separation from employment. I hereby release all previous employers, individuals, or institutions including Provide Care, Inc. from any and all liability whatsoever that might be incurred in furnishing such information. I understand that consideration for employment is conditioned upon the results of these reference checks. I understand that if hired by Provide Care, Inc., I authorize release of my entire personnel file to county social service agencies/and MN Dept. Of Human Services for the purpose of fulfilling licensing requirements. A copy of this signed release shall have the same force and effect as the original release signed by me and is valid for up to two months from the date below.