Fillable Children Youth & Families Department CRC Application Fingerprint (NM Children, Youth & Families Department - CYFD)

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Children Youth & Families Department CRC Application Fingerprint (NM Children, Youth & Families Department - CYFD)

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Children Youth & Families Department
Protective Services Division/Placement, Prevention & Adoption Resource Bureau/
Criminal Records Check Unit
CRC Application
*Form shall be typed. Form will be rejected if information is missing. *
Please ensure you are using the most updated forms. Vist https://cyfd.org/for-providers/info-and-
manuals for further instructions and updated forms. Please follow all the directions. If you have any
questions, please call (505)827-8400 or email us at CYFD.PSCriminalReco@state.nm.us.
Fingerprint Registration Information
Agency Information
Registration ID# :
you will receive this ID# after you have completed Step #2 registering your applicant to be fingerprinted.
updated 10.08.2020
*Type of Agency:
*E-mail:
, NM
*Zip
Applicant Information
*First Name
*Middle Name
No Initials. If none then NMN
*Last Name
*Aliases / AKA / Madien Name, Jr., Sr., nick name(s) etc.
If none then N/A
* Place of Birth
City, State
*Social Security Number
9 digits
*Date of Birth
mm/dd/yyyy
*Drivers License Information
State DL#
*Physical Address
Include apartment / unit # if applicable
*City
, NM
*Zip
*Citizenship
*Race
*Height
*Weight
*Phone #
*Eye Color
drop down box
*Hair Color
drop down box
*Sex Female
Male
The following documentation shall be Emailed to our office:
1. CRC Application
2. Fingerprint Submission Receipt
Not registration reciept
Please see step #3 under instructions online.
3. Child Abuse & Neglect Form
These documents shall be Emailed to:
CYFD.PSCriminalReco@state.nm.us
*City
*Court Docket:
*Agency Name:
*Phone #:
*Mailing Address:
*Contact Person:
Applicant Status:
TFC Status:
Court Name:
Choose the following ORI when registering applicants:
TFC
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Children Youth & Families Department CRC Application Fingerprint (NM Children, Youth & Families Department - CYFD)

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Completed 4 March 2021

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