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I hereby authorize and empower the Village of Minooka and the Minooka Police Department, the Chief of Police, any consumer reporting agency, or other outside service company engaged by said officials, to obtain, prepare, use and furnish information concerning my current and former employment, current and former business practices, credit, general reputation, and personal characteristics. I respectfully request that you furnish to the Minooka Police Department, the Chief of Police any and all information that you have concerning me, my background, my business background and reputation. This information is to be used to determine the eligibility for the issuance of a permit to sell products in the Village of Minooka. I hereby release you and/or your employer from any liability and/or damage of whatsoever nature, on account of furnishing the information requested above.
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121 McEvilly Road
Minooka, IL 60447