AUTHORIZATION_FOR_RELEASE_OF_INFORMATION_5lZH5R1.pdf

AUTHORIZATION FOR RELEASE OF INFORMATION I,_________________ (Client's Name), born on (Date of Birth)_____________________, hereby authorize, G&H Pathways, to disclose to and/or receive from third parties any relevant verbal and/or written information regarding the following immigration matter____________________________________________________. I authorize this release for the duration of my legal proceedings before this Immigration Consulting firm as my designated representatives. I understand that G&H Pathways will notify me prior to providing or obtaining any information relating to my case to or from any individual or entity. I further understand that I may revoke this authorization at any time. _________________________________ (Signature) (or parent/guardian if client is a minor) _______________ Date ________________________________________ (Signature) (Emiliano Gonzalez/Vanesa Hernandez, G&H Pathways) _________________ Date