Vermilion Parish Police Jury Release of Employee Information Authorization

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Vermilion Parish Police Jury Release of Employee Information Authorization

Enter the information for the employee you are requesting information about. Employee can give their signature authorization on this form or you can upload a signed employee authorization at end of this form. ONLY FOIA request(s): For more than one specific employee or no employees, input Employee Group as first and last name. For SSN data, input all zeroes. For birth date, select today's date.

Date of Application *

YYYY

Employee Information

Full Name *

Last, First & Middle Initial

Last 4 SSN *

Birth Date *

YYYY

Information Request Type

Details for Information Release

List as specifically as possible for all selections above except employment verification type request(s).

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