RELEASE OF INFORMATION

If you are requesting that information be released to yourself or another party, you
may request it using the form located below. Once you return the form and a fee,
we will be able to prepare and send out your information.

Please print the form below and fill it out. You may either drop it
off, mail it to our main office, or fax it.

Mailing Address
1489 Baltimore Pike
Bldg. 200, Ste. 250
Springfield, PA 19064

Fax Number
(610) 604-9510

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AUTHORIZATION FORM

Release Authorization Form