Form SFN 11639 - Jun 2012

The SFN 11639 form is used to authorize the release of information from an individual or organization. This form is typically used when someone needs to obtain information from another party, such as medical records or employment history. By filling out this form, the requesting party is giving permission for the information to be released to them.

Individuals or organizations requesting the release of information.

The completed Form SFN 11639 should be submitted to the entity that will be releasing the information.