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Get CT DPS-0846-C 2012

TION STATE OF CONNECTICUT CRIMINAL HISTORY RECORD REQUEST FORM (PLEASE TYPE OR PRINT CLEARLY) Check Type of Background Search Requested: ( ) Conn. Only search by Name/Date of Birth - $36.00 (will only provide existence of a record and not actual record) ( ) Conn. Only Criminal Conviction History Record Search-$50.00 (Name/DOB Search, will provide a copy only if a record exists) ( ) Conn. Only Criminal Conviction History Record searched by Fingerprint - $50.00* *Fingerprinting completed at a Co.

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