Form G-197 Authorization to Disclose Information 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your personal information in the designated fields, including your name, date of birth, RRB claim number, and social security number.
3. In the section titled 'Whose Records to be Disclosed', specify the medical and educational sources from which you authorize information to be released. This includes hospitals, clinics, schools, and any other relevant entities.
4. Clearly indicate the purpose of this authorization by selecting 'Determining my eligibility for railroad retirement disability benefits'.
5. Review the certification section carefully. Ensure you understand your rights regarding revocation of this authorization before signing in Item B.
6. Sign and date the form using blue or black ink. If applicable, include signatures from a parent or guardian if required by state law.

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