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Get Oh Shr-web Check 2018-2024

Franklin County Sheriff s Office 410 S. High Columbus OH 43215 614-525-5090 Mon. - Fri. 7 30am - 1 30pm Type of Background Check needed o BCI State of Ohio only o 30. I certify that the personal identifiers provided on this form are accurate and I voluntarily and knowingly authorize this WebCheck agency 3MU387 Franklin County Sheriffs Office to submit information to the Ohio Bureau of Criminal Identification and Investigation BCI I to conduct a criminal records check for information relating to me. I voluntarily and knowingly authorize BCI I to disseminate criminal arrest conviction and juvenile delinquency adjudication records to the WebCheck provider or agency I have designated to receive this information. I voluntarily and knowingly release and discharge the Ohio Attorney General s Office BCI I and their employees from all claims and liability related to this authorized criminal record review and dissemination. By signing this form the applicant acknowledges that all information on this form is accurate. Any mistakes or errors on this form are the responsibility of the applicant. Signature Completed by Sheriff s Technician SHR-Web Check Form Rev. 5-18 Date. 00 Web Check FBI Nationwide Check only o BFBI Both Ohio Nationwide Checks 60. 00 Please Print Clearly Last Name First Name Date of Birth SSN Address City State Zip Phone Reason for Background Check Code Direct Copy Circle only One BMV Dealer License BMV Deputy Registrar Child Care Center Type A ODJFS Occupational Therapy Physical Therapy and Athletic Trainers Board Ohio Board of Nursing Ohio Board of Pharmacy Ohio Department of Education Ohio Medical Board Ohio Veterinary Medicine License Board OPOTA Transaction Respiratory Care Board Social Worker Board State Vision Professional Board State Speech Hearing Professional Board Cannot be mailed to an additional address Mail Background Check Results to Company Name Contact If Any Phone Number All Checks are conducted by the Ohio Bureau of Criminal Identification Investigation London Ohio. For the status or question regarding the background check s please contact them at 877 224-0043 or 740 845-2000. I certify that the personal identifiers provided on this form are accurate and I voluntarily and knowingly authorize this WebCheck agency 3MU387 Franklin County Sheriffs Office to submit information to the Ohio Bureau of Criminal Identification and Investigation BCI I to conduct a criminal records check for information relating to me. I voluntarily and knowingly authorize BCI I to disseminate criminal arrest conviction and juvenile delinquency adjudication records to the WebCheck provider or agency I have designated to receive this information* I voluntarily and knowingly release and discharge the Ohio Attorney General s Office BCI I and their employees from all claims and liability related to this authorized criminal record review and dissemination* By signing this form the applicant acknowledges that all information on this form is accurate. Any mistakes or errors on this form are the responsibility of the applicant. Signature Completed by Sheriff s Technician SHR-Web Check Form Rev* 5-18 Date. .

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