Request For Conviction Criminal History Record

WASHINGTON STATE PATROL Identification and Background Check Section PO Box 42633 Olympia WA 98504-2633 (360) 534-2000 http://watch.wsp.wa.gov REQUEST FOR CONVICTION CRIMINAL HISTORY RECORD (RCW 10.97) $16 Fee Conviction Criminal History Record Information Based on Name and Date of Birth For a $12 fee and an immediate response using a credit card, access our web site listed above. $38 Fee Conviction Criminal History Record Information Based on Fingerprints A full set of fingerprints on a fingerprint card is required for processing. $10 Fee per Notary Seal Notary Letter(s) in Addition to Criminal History Record Check Requesting Notarized Letter(s) NOTE: The requested record information is furnished solely on the basis of name and/or description similarity with the subject of your inquiry. Positive identification or non-identification can only be effected upon receipt of fingerprints. Applicant may be advised of inquiry. * Results can only be e-mailed for name and date of birth inquiries. Fingerprint-based background checks and notary letters will be mailed. Password is required to open encrypted PDF results. SUBJECT INFORMATION: (Please type or print clearly) Applicant's Name Last First Middle Alias/Maiden Name/Other Names Used Date of Birth Month/Day/Year REQUESTOR INFORMATION: (Please type or print clearly) Name Address City State ZIP Code Contact Phone Number ( ) Would you like your results e-mailed or mailed? (Please select only one) Mailed (It may take 7 to 14 business days for response, when mailed.) E-Mailed* E-Mail Address Password (Password must be 8 - 15 characters) 3000 - 240 - 569 (R 6/18 ) American LegalNet, Inc. www.FormsWorkFlow.com