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Authorization for Release of Information to a Technical Service Provider (TSP)

If you encounter any problems with the files provided on this page, please contact Joe Little at 406-587-6861.

This release form is available in Acrobat Reader format. For best results, save the document to your computer and rename it before filling it in or printing it.

Authorization for Release of Information to a Technical Service Provider (TSP) MT-CPA-TSP-2 (PDF; 16 KB)

The authorization reads as follows:

I, (participant name) hereby authorize the Natural Resources Conservation Service (NRCS) to provide (name of TSP) with the appropriate information from my NRCS case file needed to provide technical assistance to me for implementing the following conservation practices and/or contract item numbers (CINs):

Program participant signature:

Date: