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Get VT Crime Information Center FBI National Record Check Release Form 2015

Rth Date of Birth Applicant s Telephone # City/Town Month State Day Country Year Include Area Code and Number RELEASE I, , hereby acknowledge and agree to a check of any criminal record of convictions which may be maintained by the Vermont Criminal Information Center and the FBI. I understand that the results of that check will be made available to for use in reviewing my suitability for . I further understand that I have the right to appeal.

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