I understand that in verifying my application (attached as Exhibit A) to be considered as a potential candidate for the Board of Directors of the Kauai Island Utility Cooperative (KIUC), a background check may be required. I hereby authorize KIUC to perform a background check regarding criminal records and other information provided on this form and on my application. I authorize the appropriate individuals, companies, institutions or agencies to release information, and I release them from any liability as a result of such inquires or disclosures. A report may be generated summarizing this information.
I further understand and waive my right to privacy regarding the background check and release and hold harmless KIUC and its agents from any liability.
I have a right to obtain a copy of the background check by directing a written request to KIUC.
I certify that all statements and answers on my application are true and complete to the best of my knowledge. I understand that if any statements are found to be false or misleading or that if information has been omitted, this will be cause for disqualification.
I understand that a photocopy of this authorization would be accepted with the same authority as the original.
This release will expire one year after the date of origination.