Fill - Free fillable BCIA 8705 BCIA 8705, Application to Obtain Copy of State Summary Criminal History PDF form

STATE OF CALIFORNIA DEPARTMENT OF JUSTICE

BCIA 8705

(Orig. 07/2000; Rev. 02/2017)

PAGE 1 of 3

APPLICATION TO OBTAIN COPY OF

STATE SUMMARY CRIMINAL HISTORY

(HARD CARD FD-258)

California Penal Code sections 11120 through 11127 afford a person an opportunity to obtain a copy of his or her record, if any,

contained in the files of the California Department of Justice's (DOJ) Bureau of Criminal Information and Analysis (BCIA) and

refute any erroneous or inaccurate information contained therein. Pursuant to California Penal Code section 11124, the purpose

of a record review is to provide an individual or designee indicated on the background check request with a copy of the

individual's record or notice of a No Record existence.

The applicant may use the information received to answer questions regarding past criminal history, or to complete an application

or questionnaire. Pursuant to California Penal Code sections 11125, 11142, and 11143, this process is not to be used to obtain

a copy of criminal history information to furnish to a person or agency for purposes such as certification, employment, licensing,

immigration, or visa. A violation of these sections is a misdemeanor.

The DOJ will only mail a response to the applicant and to the designee as identified by the applicant on the BCIA 8705 form.

A standard 10-print fingerprint card (FD-258) with the applicant's fingerprint impressions containing the name, descriptive data,

mailing address of the applicant, and the $25.00 Record Review background check fee in the form of a personal check drawn on

a U.S. bank, money order, certified check, or cashier's check, made payable to the California Department of Justice, must

accompany this application.

The following information is necessary to ensure the processing of your request. Failure to follow the procedures may result in a

delay in processing or rejection of your application.

TYPE OR PRINT:

Name (Last, First, Middle)

Alias (if applicable) Maiden Name (if applicable)

Home Address (Number and Street) City, State, ZIP Code

Date of Birth Sex Social Security Number California Driver's License Number

Designee's Name (if any, do not include employer) (Last, First, Middle)

Address (Number and Street) City, State, ZIP Code

REASON FOR

APPLICATION:

Signature of Applicant

Date

MAIL COMPLETED FORM TO: California Department of Justice

Bureau of Criminal Information and Analysis

Record Review and Challenge Program

P.O. Box 903417

Sacramento, CA 94203-4170

If you have questions regarding completion of this form, or inquiries regarding the status of your record review request,

contact the Record Review Section at (916) 227-3835.

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STATE OF CALIFORNIA DEPARTMENT OF JUSTICE

BCIA 8705

(Orig. 07/2000; Rev. 02/2017)

PAGE 2 of 3

APPLICATION TO OBTAIN COPY OF

STATE SUMMARY CRIMINAL HISTORY

(HARD CARD FD-258)

CALIFORNIA PENAL CODE

Article 5. Examination of Records

11120. As used in this Article, "record" with respect to any person means the state summary criminal history information as defined in

subdivision (a) of Section 11105, maintained under such person's name by the Department of Justice.

11121. It is the function and intent of this article to afford persons concerning whom a record is maintained in the files of the bureau an

opportunity to obtain a copy of the record compiled from such files, and to refute any erroneous or inaccurate information contained therein,

11122. Any person desiring a copy of the record relating to himself shall obtain an application form furnished by the department which shall

require his fingerprints in addition to such other information as the department shall specify. Applications may be obtained from police

departments, sheriff departments, or the Department of Justice. The fingerprinting agency may fix a reasonable fee for affixing the

applicant's fingerprints to the form, and shall retain such fee.

11123. The applicant shall submit the completed application directly to the department. The application shall be accompanied by a fee not

to exceed twenty-five dollars ($25) that the department determines equals the cost of processing the application and providing a copy of the

record to the applicant. All fees received by the department under this section are hereby appropriated without regard to fiscal years for the

support of the Department of Justice in addition to such other funds as may be appropriated therefor by the Legislature. Any request for

waiver of fee shall accompany the original request for the record and shall include a claim and proof of indigency.

11124. When an application is received by the department, the department shall determine whether a record pertaining to the applicant is

maintained. If such record is maintained, the department shall furnish a copy of the record to the applicant or to an individual designated by

the applicant. If no such record is maintained, the department shall so notify the applicant or an individual designated by the applicant.

Delivery of the copy of the record, or notice of no record, may be by mail or other appropriate means agreed to by the applicant and the

department.

11125. No person or agency shall require or request another person to furnish a copy of a record or notification that a record exists or does

not exist, as provided in Section 11124. A violation of this section is a misdemeanor.

11126. (a) If the applicant desires to question the accuracy or completeness of any material matter contained in the record, he or she may

submit a written request to the department in a form established by it. The request shall include a statement of the alleged inaccuracy or

incompleteness in the record, and its materiality, and shall specify any proof or corroboration available. Upon receipt of the request, the

department shall review the record to determine if the information correctly reflects the source documents, and if it does not, the department

shall make the necessary corrections and shall provide the applicant with a corrected copy of the record. If the accuracy of the source

documents is questioned, the department shall forward it to the person or agency which furnished the questioned information. This person

or agency shall, within 30 days of receipt of the written request for clarification, review its information and forward to the department the

results of the review.

(b) If the agency concurs in the allegations of inaccuracy or incompleteness of the record, and finds that the error is material, it

shall correct its record and shall so inform the department, which shall correct the record accordingly. The department shall inform the

applicant of its correction of the record under this subdivision within 30 days. The department and the agency shall notify all persons and

agencies to which they have disseminated the incorrect record in the past 90 days of the correction of the record, and the applicant shall be

informed that the notification has been given. The department and the agency shall also notify those persons or agencies to which the

incorrect record has been disseminated which have been specifically requested by the applicant to receive notification of the correction of

the record, and the applicant shall be informed that the notification has been given.

(c) If the department or the agency denies the allegations of inaccuracy or incompleteness in the record, the matter shall be

referred for administrative adjudication in accordance with Chapter 5 (commencing with Section 11500) of Part 1, Division 3, Title 2 of the

Government Code for determination of whether material inaccuracy or incompleteness exists in the record. The department shall be the

respondent in the hearing. If a material inaccuracy or incompleteness is found in any record, the department and the agency in charge of

that record shall be directed to correct it accordingly. The department and the agency shall notify all persons and agencies to which they

have disseminated the incorrect record in the past 90 days of the correction of the record, and the applicant shall be informed that

notification has been given. The department and the agency shall also notify those persons or agencies to which the incorrect record has

been disseminated which have been specifically requested by the applicant to receive notification of the correction of the record, and the

applicant shall be informed that the notification has been given. Judicial review of the decision shall be governed by Section 11523 of the

Government Code. The applicant shall be informed of the decision within 30 days of its issuance in accordance with Section 11518 of the

Government Code.

11127. The department shall adopt all regulations necessary to carry out the provisions of this article.

STATE OF CALIFORNIA DEPARTMENT OF JUSTICE

BCIA 8705

(Orig. 07/2000; Rev. 02/2017)

PAGE 3 of 3

APPLICATION TO OBTAIN COPY OF

STATE SUMMARY CRIMINAL HISTORY

(HARD CARD FD-258)

Privacy Notice

As Required by Civil Code § 1798.17

Collection and Use of Personal Information. The California Justice Information Services (CJIS) Division in the

Department of Justice collects the information requested on this form as authorized by Penal Code sections 11120

through 11127. The CJIS Division uses this information to afford persons an opportunity to obtain a copy of their record,

if any, contained in the files of the Department of Justice, Bureau of Criminal Information & Analysis, and refute any

erroneous or inaccurate information contained therein. In addition, any personal information collected by state agencies

is subject to the limitations in the Information Practices Act and state policy. The Department of Justice's general privacy

policy is available at: http://oag.ca.gov/privacy-policy.

Providing Personal Information. All the personal information requested in the form must be provided.

Access to Your Information. You may review the records maintained by the CJIS Division in the Department of Justice

that contain your personal information, as permitted by the Information Practices Act. See below for contact information.

Possible Disclosure of Personal Information. In order to afford persons an opportunity to obtain a copy of their record,

if any, contained in the files of the Department of Justice, Bureau of Criminal Information & Analysis, and refute any

erroneous or inaccurate information, we may need to share the information you give us with other government agencies.

The information you provide may also be disclosed in the following circumstances:

• With other persons or agencies where necessary to perform their legal duties, and their use of your information is

compatible and complies with state law, such as for investigations or for licensing, certification, or regulatory

purposes;

• To another government agency as required by state or federal law.

Contact Information. For questions about this notice or access to your records, you may contact the Record Review

Section manager by e-mail at recordreview@doj.ca.gov, by phone at (916) 227-3835, or via mail at:

Department of Justice

Bureau of Criminal Information & Analysis

Record Review and Challenge Program

P.O. Box 903417

Sacramento, CA 94203-4170

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