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What you get: Instant access to fillable Microsoft Word or PDF forms. Minimize the risk of using outdated forms and eliminate rejected fillings.THE EMPLOYEE AUTHORIZES THE RELEASE OF BENEFIT INFORMATION PURSUANT TO 39-A M.R.S.A. §221(5). The completed form should be faxed directly to Christina Randall,. Department of Labor, Bureau of Unemployment Compensation at 207-287-2305. Complete this form only if you want us to give information or records about you, a minor, or a legally incompetent adult, to an. Get VA Form 214142, Authorization to Disclose Information to the Department of Veterans Affairs (VA). Purpose: In signing this consent form, you are authorizing HUD and the above-named HA to request income information from the sources listed on the form. The information I am requesting is: ❑ Entire File. Complete this section, use the space provided in Part 6.