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  • Mi Cscl/lce-020 (formerly Bcs-lce-020) 2009

Get Mi Cscl/lce-020 (formerly Bcs-lce-020) 2009

G, MI 48909 517-241-9288; Fax 517-373-3085 Date: By: Print REQUEST FOR CONVICTION HISTORY Social Security Number Date of Birth Applicant's Name (Last, First, Middle) Mailing Address (Number and Street) City Occupation: License Type: Clear State Zip Code The following information is required in conjunction with your application for licensure/registration. In accordance with The Former Offenders Act, 1974 P.A. 381, as amended, this is to provide you with an opportunity to explain you.

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How to fill out the MI CSCL/LCE-020 (formerly BCS-LCE-020) online

Filling out the MI CSCL/LCE-020 form online can seem daunting, but this guide will provide clear and concise instructions to help you through the process. This form is crucial for your application for licensure or registration, particularly concerning conviction history.

Follow the steps to successfully complete the form online.

  1. Click the ‘Get Form’ button to access the form and open it in your preferred online editor.
  2. Start by entering your Social Security number in the designated field to ensure proper identification.
  3. Fill in your date of birth, ensuring the format is correct for official documentation.
  4. Input your full name as follows: last name, followed by your first name and middle initial, if applicable.
  5. Provide your complete mailing address, including the number and street, city, state, and zip code.
  6. Indicate your occupation in the specified field, as this is relevant to your licensure application.
  7. Select the appropriate license type for your application from the available options.
  8. Carefully list all convictions for felonies and misdemeanors in the provided sections, using the back of the form or an attachment if necessary.
  9. Provide the names and addresses of the sentencing courts for all listed convictions.
  10. Include the dates of your convictions and the corresponding sentences handed down.
  11. Answer the questions regarding your current status by checking 'Yes' or 'No' for each inquiry about your imprisonment or probation status.
  12. If applicable, provide the name, address, and phone number of your correctional facility, probation officer, or parole office.
  13. Indicate your release date from custody, probation, or parole in the specified field.
  14. Mention any rehabilitation programs that you have participated in or completed.
  15. Read the certification statement carefully, sign the form, and enter the date of signing.
  16. Review all the information you have entered for accuracy before saving your changes and choosing to download, print, or share the completed form.

Complete your MI CSCL/LCE-020 form online today to ensure your application is processed smoothly.

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  • Bill of Sale
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MI CSCL/LCE-020 (formerly BCS-LCE-020)
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