License Search Authorization

Search Authorization

I understand that consumer reports may be obtained as part of my employment with SEACAMP San Diego. These may include personal and confidential information that might be found on a Motor Vehicle Report or similar reports. I hereby Authorize SEACAMP San Diego and/or its insurance company or broker to procure such reports about me, and to share the information contained in such reports about me, and to share the information contained in such reports with each other as they deem appropriate to evaluate my insurability risk rating or for other permissible purposes.

Yes, I understand

Upload Driver's License

Upload Copy of your Driver's License

Maximum file size: 134.22MB

Signature

First Name

Last Name

I have read, understand, and authorize the search on my driver’s license with my signature below. If signed electronically, I understand and agree that my electronic signature is the legal equivalent of my manual, handwritten signature. By electronically signing this document, I consent to be legally bound by this agreement.

Yes, I understand

Signature

Clear

Date

If you are human, leave this field blank.

Upload Your Profile