Records Release Authorization Form
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| Revised 9-01-11 |
| RECORDS RELEASE AUTHORIZATION--RETIREMENT BENEFITS |
EMPLOYEE'S NAME: |
| EMPLOYEE'S SOCIAL SECURITY NUMBER: XX-XXX- |
| EMPLOYEE'S PERSONNEL ID NUMBER:
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TO: Executive Director or designee
Fire and Police Pension Fund, San Antonio (the “FUND”)
11603 W. Coker Loop, Suite 201
San Antonio, Texas 78216
You are requested to supply the following information to [Name and Address of Attorney]:
I hereby authorize the Fund to release to the attorney identified above,
or any individual submitting a request on behalf of such attorney, all requested information pertaining to my
contributions to the Fund or any of my benefits as a member of the Fund, or both. .... Read More
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