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Making a knowing and willful false statement on this DD Form 369 may be punishable by fine or imprisonment or both. DATE YYYYMMDD 15. TITLE LAW ENFORCEMENT AGENCY MAIL TO DD FORM 369 JUL 2010 16. VERIFIED BY Signature RECRUITING AGENCY MAIL FROM PREVIOUS EDITION IS OBSOLETE. Reset Adobe Designer 8. 1. DATE OF REQUEST POLICE RECORD CHECK YYYYMMDD OMB No. 0704-0007 OMB approval expires Jun 30 2011 The public reporting burden for this collection of .

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