Fort Scott, KS · Bourbon County
Authorization to Release Information Agreement
This agreement authorizes the City of Fort Scott to obtain personal, public, private, and confidential records to investigate an applicant for a cereal malt beverage, taxi driver, or solicitor license.
- licensed online notary
- ~15 min average
- Notarized PDF emailed
What you’ll need
- Government-issued photo ID
- Webcam-enabled device (laptop or phone)
- This form, ready to upload as a PDF
What this form is
The form gives the City of Fort Scott permission to request records and background information about the person applying for a cereal malt beverage, taxi driver, or solicitor license. It also includes releases of liability and states that the authorization lasts 120 days from the applicant’s signature. The applicant completes and signs the form so the city can use it in its licensing procedures.
Who needs it
Applicants for a City of Fort Scott cereal malt beverage, taxi driver, or solicitor license use this form to authorize a background investigation.
Why it needs a notary
The form has an acknowledgment before a notary public; the applicant signs the release and personally acknowledges its execution before the notary.
How to get this notarized
- 1
Download the Form
Get the Authorization to Release Information Agreement from the City of Fort Scott.
- 2
Fill In Your Information
Enter your identifying details and indicate whether you are applying for a cereal malt beverage, taxi driver, or solicitor license.
- 3
Book an Online Notary
Arrange a session with a commissioned online notary for the form’s acknowledgment.
- 4
Sign on Video
Sign the release during the online notarization session and complete the acknowledgment process.
- 5
Submit to the City
Provide the notarized release to the City of Fort Scott with your license application.
Preview the form
The blank PDF straight from Fort Scott. Look it over, then upload your filled copy to start the notary session.
You’ll need ID and a webcam.
A licensed online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.
Frequently asked questions
- How do I complete the information release?
- Fill in your identifying details, select the license type, and sign before a notary. Submit the completed form to the City of Fort Scott as part of your license application.
- Do I need to sign this form in front of a notary?
- Yes. The form includes an acknowledgment for a notary public. Sign it before the notary, who completes the acknowledgment and notary signature and seal fields.
- Can I use a commissioned online notary?
- Kansas law authorizes remote online notarization by a commissioned online notary under K.S.A. 53-5a15, and K.S.A. 53-5a11 recognizes certain notarial acts performed by an authorized officer of another state. Confirm with the city if unsure.
- How long is the authorization valid?
- The form states that the waiver is valid for 120 days from the date of your signature.