CRIMINAL RECORD CHECK
(Please print your completed form and submit to SLED. You may want to print a copy for your records.)
FULL NAME (with middle name):
AKA and/or MAIDEN NAMES:
DOB: SSN:
(Federal law permits governmental agencies to require a social security number in order to conduct official
business; however, private entities may only obtain social security numbers if given voluntarily).
(A self addressed stamped envelope is required for the return of background
PLEASE NOTE:
The fee is twenty-five dollars ($25) unless you are a charitable organization approved for a fee of eight dollars ($8). A charitable
organization must include its name and User ID number or the request may not be processed. Payment must be business check,
certified/cashier’s check or money order payable to SLED. PERSONAL CHECKS and CASH WILL NOT BE ACCEPTED. This
report contains records of arrests and convictions made by state/local agencies in South Carolina only. Alteration of a completed
criminal record check may subject a person to criminal prosecution. A completed criminal records check should not be accepted
unless it bears an original SLED stamp.
*S
LED RECORDS SECTION HAS BEEN CLOSED TO THE PUBLIC SINCE DECEMBER 15, 2008.
(CJ-022)
Revised 09/25/15
CHARITABLE ORGANIZATIONS AND SCHOOL DISTRICTS ONLY
NAME OF ORGANIZATION: _____________________________________________________________________
VERIFICATION NUMBER (as provided by SLED for online checks):________________________________
SCHOOL DISTRICTS ONLY – POSITION APPLIED FOR:_______________________________
(A self addressed stamped envelope is required for the return of background check)
