I hereby authorize the interviewer to record my statements, using whatever computer and recording devices are required for that purpose.  I understand, however, that I may stop talking, and terminate this interview at any time, without prejudice.  In this event the interview offer will be treated as "declined," and will be so reported back to me.

I have been made aware that, upon completion of this interview, my recorded statements will be analyzed for veracity by examiners professionally trained by Truth and Detection Technologies, LLC (TDT), and that the results of that analysis will be reported to me but not to the public, unless so reported by me myself.

I do release, absolve, and hold forever harmless, the interviewer and witness shown below, the TDT-trained examiners or other persons associated with TDT, and the American Truth In Politics Association and its several affiliated State Truth in Politics Associations, including their clients, agents, agencies, firms, interviewers, employees, and anyone acting on their behalf, from any liability flowing from any matter, act, or thing arising out of the aforementioned interview and examination, including, but not limited to, the results or opinions therefrom.

I am willing to submit to an interview and truth verification examination freely without promise of reward, without threat, force, or duress being exerted on me.  I have carefully read this authorization and release, and agree fully to the conditions herein.
 

Signed ________________________________Examinee

Signed ________________________________Witness

Signed ________________________________Interviewer

Date _______________    Time ____________

Location ______________________________
 

Rev. 2, 12/15/09