Criminal Record Disclosure Letter Template

You can open the Criminal Record Disclosure Letter Template in multiple formats, including PDF, Word, and Google Docs.

Open Template

Sample

Criminal Record Disclosure Letter Template

Printable | Editable Form

PDF 1 PDF 2

Examples

Criminal Record Disclosure Letter Template (1)
To:
[Recipient’s Name]
[Recipient’s Title/Position]
[Recipient’s Address]
From:
[Your Name]
[Your Address]
[Your Phone]
[Your Email]
Date:
[Date]
Subject:
Criminal Record Disclosure Request
Introduction:
I am writing to formally request a disclosure of my criminal record as per the applicable regulations and laws. This letter serves to outline my request and provide any necessary information required for processing.
Personal Information:
Full Name: [Your Full Name]
Date of Birth: [Your Date of Birth]
Social Security Number: [Your SSN or ID Number]
Address: [Your Current Address]
Details of Request:
I request a full disclosure of any criminal records, including arrests, charges, and convictions. This request is made for the purpose of [State purpose, e.g., employment, licensing].
Background Information:
Please provide any applicable contextual information related to my criminal record, including the nature of offenses, dates, and final dispositions.
Authorization:
I hereby authorize the release of my criminal record to [Recipient’s Name/Title] and acknowledge that any information retrieved will be used in accordance with relevant legal guidelines.
Contact Information:
For any questions regarding this request, please feel free to contact me at [Your Phone] or [Your Email].
Sincerely,
[Your Signature]
[Your Printed Name]
Criminal Record Disclosure Letter Template (2)
To:
[Authority’s Name]
[Authority Title or Department]
[Authority Address]
From:
[Your Name]
[Your Address]
[Your Phone]
[Your Email]
Date:
[Date]
Subject:
Request for Criminal Record Check
Statement of Purpose:
I am requesting a record check due to [describe situation, e.g., job application, personal reasons]. This disclosure is essential for [explain necessity, e.g., compliance with employment requirements].
Requisite Information:
Please find the following information included with this request:
– Full Name: [Your Full Name]
– Date of Birth: [Your Date of Birth]
– Address: [Your Current Address]
– Previous Addresses (if relevant): [List previous addresses]
Additional Documents:
Attached are copies of necessary identification documents, including [list documents, e.g., ID, Driver’s License].
Expected Response:
I kindly request that you process this request promptly and notify me of any findings at your earliest convenience.
Legal Disclaimer:
I understand that the information provided may be subject to verification and that I have the right to contest any inaccuracies.
Thank you for your attention to this matter.
Sincerely,
[Your Signature]
[Your Printed Name]

Template Online

Format

Please complete the form below to create the Criminal Record Disclosure Letter Template. All fields must be filled out to ensure a clear and complete disclosure. We provide examples to guide you through each step.

Criminal Record Disclosure Letter Template

1. Requested By


2. Subject Information


3. Request Details

4. Disclosure Information

5. Legal Basis for Request

6. Confidentiality Terms

7. Acknowledgment and Signature

8. Declaration and Signatures



PDF

WORD

Google Docs

Printable

Criminal Record Disclosure Letter Template

Printable | Editable Form

PDF 1 PDF 2

Criminal Record Disclosure Letter Template