I, hereby authorize Masonic Care Community to submit a request to the Attorney General of the United States to conduct a search of the records of the Criminal Justice Information Services Division of the Federal Bureau of Investigation for any criminal history records corresponding to the fingerprints or other identification information submitted by me. I further authorize the exchange of such information between the Attorney General of the United States, the New York State Department of Health and Masonic Care Community, and within its healthcare system (i.e. among "sister" nursing homes/home care agencies). This information may be used by Masonic Care Community and only for the purpose of determining my suitability for employment.
I further authorize and request any present or former employer, educational institution, law enforcement agency, financial institution, or other persons having personal knowledge about me to furnish to the Masonic Care Community, and/or its agents, with any and all information in their possession regarding me, in connection with an application of or retention of employment. I hereby release from liability and hold harmless all persons and corporations supplying this information. A photocopy of this authorization is an effective as the original.