Fillable Criminal History Forms (North Central Texas College)

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Criminal History Forms (North Central Texas College)

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File type: PDF

U.S.A. forms for North Central Texas College

BROWSE NORTH CENTRAL TEXAS COLLEGE FORMS

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DPS Computerized Criminal History (CCH) Verification
I, _______________________________________, have been notified that a computerized criminal
APPLICANT or EMPLOYEE NAME (Please print)
history (CCH) verification check will be performed by accessing the Texas Department of Public
Safety Secure Website and will be based on name and DOB information I supply.
Because the name based information is not an exact search and only fingerprint record searches
represent true identification to criminal history, the organization (as listed below) conducting the
criminal history check is not allowed to discuss any information obtained using this method, therefore
the agency may offer the opportunity to have a fingerprint search performed to clear any
misidentification based on the name search, if the search provides a criminal report I know could not
be mine.
For the fingerprinting process I will be required to submit a full and complete set of my
fingerprints for analysis through the Texas Department of Public Safety AFIS (automated fingerprint
identification system). I have been made aware that in order to complete this process I must have the
correct fingerprinting (FAST) form from this agency, make an online appointment, submit a full and
complete set of my fingerprints, and pay a fee of $24.95 to the fingerprinting services company,
L1Enrollment Services.
Once this process is completed and the agency receives the data from DPS, the information on
my fingerprint criminal history record may be discussed with me.
(This copy must remain on file by your agency. Required for future DPS Audits)
___________________________________
Signature of Applicant or Employee
Date
North Central Texas College__________
Agency Name (Please print)
Kay Schroeder________________________
Agency Representative Name (Please print)
___________________________________
Signature of Agency Representative
Date
Please:
Check and Initial each Applicable Space
CCH Report Printed:
YES
NO
initial
Employment
Hire
d
Not Hired
initial
Date Printed:
/
initial
Destroyed Date:
initial
Retain in your files
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signature
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CRIMINAL HISTORY/DRIVING RECORD
RELEASE FORM
North Central Texas College may conduct a criminal history record on prospective employees. Please TYPE or PRINT the
information requested below and sign the release form.
*NAME:___________________________________________________________________________
Last
First
Middle
Current Address
Street_________________________
Apartment # ______________________
City _________________________
State__________
Zip ____________
*Driver’s License # _______________________________
State __________
Exp. Date________
* Date of Birth ___________________________________
*Social Security #
________________
Previous Address:
Street _______________________
Apartment# _______________
City _________________________
State __________
Zip ___________
I hereby authorize North Central Texas College to conduct a criminal history check.
________________________________________ _________________________
Signature Date
Requested By ___________________________
Criminal History Results Driving Record Results
Date ________ Date _________
Initials ________ Initials _________
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Completed 27 July 2020

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