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OSPRA 104 10/07 Authorization to Forward Criminal History Record Information from the City School District of the City of New York to the New York State Education Department Office of School Personnel Review and Accountability NYS Education Department ph 518 473-2998 www. Highered.nysed.gov/tcert/ospra OSPRA mail.nysed.gov Type or Print All Information Instructions to Applicant Please complete Sections 1 2 and 3 and mail the form to the address in Section 4. Please Note This form is to be filed by individuals who have been previously fingerprinted after July 1 1990 for a license and/or employment by the New York City Board of Education NYCBOE and are authorizing the NYCBOE to forward their criminal history to the New York State Education Department for certification application and/or employment purposes. SECTION 1 Inaccurate or incomplete information will delay processing Name Last First Middle Sex M/F Home Address Street Apt. Social Security Number City State Zip Telephone Area Code ....

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How to fill out the NY OSPRA 104 online

The NY OSPRA 104 form is a crucial document for individuals looking to authorize the forwarding of their criminal history record to the New York State Education Department. This guide will provide you with clear instructions to complete the form accurately and efficiently, ensuring a smooth submission process.

Follow the steps to complete your NY OSPRA 104 form online.

  1. Press the ‘Get Form’ button to access the NY OSPRA 104 form. This will open the form in an online editor for you to fill out.
  2. In Section 1, begin by entering your personal information. Provide your last name, first name, and middle name. Select your gender using the options provided (M/F/X), and fill in your home address, including street address and apartment number. Ensure you include your city, state, and zip code. Don't forget to enter your telephone number with area code, email address, and date of birth in the specified format.
  3. In Section 2, choose one option that best describes your employment status with the NYC Board of Education. You must select one of the three options regarding whether you are seeking clearance for certification or for employment.
  4. Proceed to Section 3, which requires you to authorize the NYC Board of Education to forward your criminal history records. Read and understand the statements provided. You will need to sign and date the form to confirm your authorization.
  5. Once you have completed all required sections, proceed to Section 4. You will submit the completed form through the HR Connect Web Portal. Log into the portal, click on ‘Upload Documents,’ and fill in all necessary fields. Select the appropriate category from the drop-down menu, add 'OSPRA 104 form' in the subject field, and include any relevant notes. Finally, attach your completed form and click Submit to complete your submission.

Complete your NY OSPRA 104 form online today to streamline your certification and employment process.

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ospra 104 - New York State Education Department
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Related links form

NY DTF CT-3-M (formerly CT-3M/4M) 2019 NY DTF IT-2104 2020 CA BOE-1150 2014 NY DTF IT-201-ATT 2019

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