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Waiver of Confidentiality
In acknowledgement that {Company}, a potential employer, requires access to {information} for employment purposes:
I, the undersigned, hereby waive my right of confidentiality regarding the following information: {information}. I waive my right of confidentiality for {Company} only and any of its employees, officers, agents, or representatives.
This waiver does NOT extend to the following information, which shall remain confidential: {information}
____________________________________
Signature
_________________________________
Date
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