Confidential Information Release Form

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This is a template that can be used to give a party permission to divulge certain confidential information. This template includes a description of the materials that are released from confidentiality and allows for additional restrictions or comments. Additionally, this template can be customized to provide for any user specific language that may be necessary. This template should be used by small businesses or other entities that want to release certain confidential information.

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									This is a template that can be used to give a party permission to divulge certain
confidential information. This template includes a description of the materials that are
released from confidentiality and allows for additional restrictions or comments.
Additionally, this template can be customized to provide for any user specific language
that may be necessary. This template should be used by small businesses or other
entities that want to release certain confidential information.
              CONFIDENTIAL MATERIALS RELEASE FORM
To:                         ____________________
From:                       ____________________
Date:                       ____________________
Contact Person:             ____________________

All materials released under this form are covered by the terms and conditions of:

         Name of Contract:           _______________
         Date of Contract:           _______________

Description of Materials Released:




Additional Restrictions and Comments:




Acknowledged and Agreed to by:

[COMPANY NAME]                                                   Accepting Party:

Date: ______________________                                     Date: ____________________

By: _______________________                                      By: _______________________
Signature                                                        Signature
__________________________                                       __________________________
Print Name                                                       Print Name


                           Please sign above, print name and date, and return to:

                                               [COMPANY NAME]
                                                  [ADDRESS]




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