IDENTIFICATION UNIT | 690 Kipling Street, Suite 3000 | Denver, CO 80215 | (303) 239-4208 | www.colorado.gov/cbi
Public Request for Criminal History Record Information
Please type or print clearly | $13.00 per name (no personal checks) | Reply will be mailed in 3-5 business days
Please call (303) 239-4208 with any inquiries. Discrepancies must be reported within 30 days.
First Name: Middle Name:
Date of Birth (required):
Gender (optional):
Social Security Number (optional):
MALE FEMALE
MM/DD/YYYY
SEND REPLY TO
Name of Business and/or Person
Street Address or P.O. Box
State
ZIP Code
Phone Number
PURPOSE FOR REQUEST
Public Request/General Inquiry Emergency Medical Technician Security Guard
Housing P.O.S.T. Board Adoption
Visa / International Travel Immigration Guardian/Conservator
PLEASE READ AND SIGN BELOW
The record you may receive is for lawful use only and summarizes information sent to the Colorado Bureau of Investigation from fingerprint
contributors in the state of Colorado. Unless fingerprints accompanied your inquiry, the Colorado Bureau of Investigation cannot guarantee this
record relates to the person in whom you have an interest. If the disposition is not shown, or further explanation of an arrest charge or disposition is
desired, that information may be obtained from the agency who furnished the arrest information. Only the court of jurisdiction or the respective
District Attorney's office wherein the final disposition occurred can provide an official copy to any specific disposition. State law governs access to
sealed records. Because additions and deletions to a criminal history record may be made at any given time, a new inquiry should be requested when
needed for subsequent use. Any report received from the Colorado Bureau of Investigation as the result of this inquiry shall not be used for the direct
solicitation of business for pecuniary (monetary) gain.
Signature of Requesting Party (required per State law)
DF3
Revised 7/13/2015
NOTARIZING
Do you need the response notarized?
YES NO
Notarizing may add up to three business days to your processing time.
Co Dept of Public Safety-Div. of Fire Prevention and Control ATTN:F&LS Section
700 Kipling Street, Suite 4100
Denver CO 80215 303.239.4100
