ࡱ> bda @ \1bjbj00 XRR:H}@@@@8,-* (HHH!BC!,o!)))))))$+Rm-)9.% ^!.%.%)@@HH[)(&(&(&.%:@RHH)(&.%)(&(&"(&H PX6h%R(&&)0-*(& .%R .(&@@@@ .(&|!Q"(&"tU#!!!))D.d &.  STATE OF SOUTH CAROLINA DEPARTMENT OF CONSUMER AFFAIRS PRENEED FUNERAL CONTRACTS  HYPERLINK "http://www.scstatehouse.net/code/t32c007.htm" S.C. Code Ann. 32-7-10 et seq.  HYPERLINK "http://www.scconsumer.gov" www.scconsumer.gov 803-734-4236/800-922-1594 AUTHORIZATION TO RELEASE INFORMATIONI,  FORMTEXT      do hereby authorize the release of financial and criminal background information to the South Carolina Department of Consumer Affairs and its agents. I understand that any personal information will be used in regard to the application for a license to sell preneed funeral contracts.I also understand that this authorization releases the South Carolina Department of Consumer Affairs from any legal action. Signature of Applicant FORMTEXT      Date of Birth;WXūņmXmAmX,hhh 0J5B*CJOJQJaJph(hhh 5B*CJOJQJaJph1jhhh 5B*CJOJQJUaJphh B*CJOJQJaJph(jhH^:hgCJUaJmHnHu3jhg5>*CJOJQJU\aJmHnHuhh CJOJQJaJh~bh CJOJQJaJ0jh~bh CJOJQJUaJmHnHuhvW   6 7 8 0*Z0*k0*L0*l.0*V0*V0*<0*Z0*Z$ZZ$ZDkd$$IfTl2%% t644 laT $$Ifa$gd{hgd %d &d O P gd gd\V /`0Z1   5 A D E F P ˷ː{f_[SNFA7Ajhl%5U hl%5hl%CJaJ h 5h\Vh 5h  htS h )h 0J56:;CJOJQJ\aJ)hzh 0J56CJOJQJ\aJ hzh 0JCJOJQJaJ+jhzh CJOJQJUaJ&hzh 0J6CJOJQJ]aJ/jhzh 0J6CJOJQJU]aJ8hhh 0J56:;B*CJOJQJ\aJph8 9 : ; < Z$ZiZ$ZDkd$$IfTl2%% t644 laT $$Ifa$gd{hDkdi$$IfTl2%% t644 laT< = > ? @ Z$ZiZ$ZDkd$$IfTl2%% t644 laT $$Ifa$gd{hDkdi$$IfTl2%% t644 laT@ A E  L Z~VD$Vlkd]$$IfTlF2%V3 t6    44 laT $Ifgd{hDkdi$$IfTl2%% t644 laTP Q  L N P R N P R T V X Z \ ^ ` b d h j ...½½½½½½½½½½½ʔ½½½½U"jhl%CJUaJmHnHu#j hl%hl%CJUaJjhl%CJUaJhl%h CJ aJ h 5h CJaJhl%CJaJ hl%5jhl%5UmHnHujhl%5Ujhl%hl%5U2L N P R N $VjU$VDkd$$IfTl2%% t644 laT $Ifgd{hFkd$$IfTl2%% t644 laTN P R T V $VlU$VDkd$$IfTl2%% t644 laT $Ifgd{hDkd$$IfTl2%% t644 laTV X Z \ ^ U$VlU$VDkd$$IfTl2%% t644 laT $Ifgd{hDkd$$IfTl2%% t644 laT^ ` b d f h U$VlU VVDkd$$IfTl2%% t644 laT $Ifgd{hDkd$$IfTl2%% t644 laTh j U v-V:U VVWkd $$IfTl0F2% t644 laT $Ifgd{h $$Ifa$gdl%Wkd $$IfTl0F2% t644 laT U VVFU: VV $$Ifa$gdl%Wkd $$IfTl0F2% t644 laT $Ifgd{hWkdg $$IfTl0F2% t644 laT U v-V:U VVWkd $$IfTl0F2% t644 laT $Ifgd{h $$Ifa$gdl%Wkd $$IfTl0F2% t644 laT t.v.U VVFU: VV $$Ifa$gdl%Wkd $$IfTl0F2% t644 laT $Ifgd{hWkd_ $$IfTl0F2% t644 laT FORMTEXT     -  FORMTEXT    -  FORMTEXT     Applicant s Social Security NumberSWORN TO AND SUBSCRIBED before methis _____ day of _____________, 20___Notary PublicMy Commission Expires: Authorization Release Revised 08/06 Page  PAGE 1 of  NUMPAGES 1 Street Address 3600 Forest Drive, 3rd Floor Columbia, SC 29204-4406 Mailing Address P.O. 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