RE: APPLICATION OF:
AUTHORIZATION AND RELEASE
Date
(Name of Applicant)
I hereby authorize all such persons set forth above to answer any inquiries and questions submitted to them by a Character
Committee, the State Board of Law Examiners, the Supreme Court of Maryland or their authorized representatives, and to
appear before any and all of these bodies and to give full and complete testimony concerning the undersigned including
any information furnished by the undersigned.
I hereby relinquish any and all rights to said reports, including, but not limited to, employment, personnel and/or
scholastic records, or any other information incident in any way to the cooperation of any entity with the Character
Committees, the State Board of Law Examiners, the Supreme Court of Maryland or their authorized representatives, and
fully understand that I am not entitled to have disclosed to me the contents of any of the foregoing, except as provided for
in Maryland Rule 19-105.
I solemnly affirm under the penalties of perjury and upon personal knowledge that the contents of the
forgoing paper are true.
Signature of Applicant
I, , having filed with the Maryland State Board of Law Examiners a Character
Questionnaire, and fully recognizing the responsibility to the Public, the Bench, and the Bar of the State, lodged with the
duly appointed Character Committees and the State Board of Law Examiners by the Supreme Court of Maryland under
the applicable State statutes and Rules of Court to determine that only those of good moral character, fitness and ability
are admitted the Bar in Maryland, hereby authorize and request every police department, employer, school official, and
every other person, firm, officer, corporation, association, organization, or institution, pubilc or private, having control of
any documents, records, or other information pertaining to me that is relevant to my good moral character and fitness to
perform the responsibilities of an attorney, to furnish the originals or copies of any such documents, records or other
information to the Character Committee, the State Board of Law Examiners, or any of their representatives, and to permit
any of all of the said bodies, or any of their representatives, to inspect and make copies of any such documents, records,
and other information including but not limited to employment, personnel or scholastic records.
FOR USE BY THE SUPREME COURT OF MARYLAND, THE STATE BOARD
OF LAW EXAMINERS, AND THE CHARACTER COMMITTEES OF THE SUPREME COURT OF MARYLAND
(Applicant's Alternate Name(s), if applicable)
I hereby release and exonerate every employer, school official, and every other person, firm, officer, organization, or
institution that shall act in good faith with the authorization and release provided herein, from any and all liability of every
nature and kind growing out of or in any way pertaining to the furnishing or inspection of such documents, records and
other information or the investigation made by said Character Committees, the State Board of Law Examiners, the
Supreme Court of Maryland, or their authorized representatives. I further waive, absolutely and forever, any privilege not
protected by the Constitutions of the United States of America or the State of Maryland that I may have regarding
information bearing on my good moral character and fitness to perform the responsibilities of an attorney under applicable
Maryland law. I hereby authorize the State Board of Law Examiners and the Supreme Court of Maryland, with respect to
any and all information received with this authorization and release, pursuant to Maryland Rule 19-105, to forward said
information to any other admitting authority where I have applied or may later apply for admission to the practice of law.
Further pursuant to Maryland Rule 19-105, I understand that the State Board of Law Examiners may release certain
identifying information about me (including, but not limited to, my name, address, telephone number, email address,
Social Security Number, date of birth, date of application, date of examination(s)), and exam results to the Supreme Court
of Maryland, the Client Protection Fund of the Bar of Maryland, and the National Conference of Bar Examiners, my law
school, and/or any authorized agent of those bodies. I further understand that each academic and employment certification
and personal reference form appended to this Character Questionnaire will be sent to the entity or individual listed
thereon.
Applicants SSN (last 4)