A. PERSONAL INFORMATION
B. PERSONS FOR CHECK
- You may add additional entries for persons as required.
Employees
individual(s) currently employed by your company.- Alfie Bower
- Cole Brooks
- Cole Hamilton
- Luna McMillan
- Zayde Crow
- Aaron Newton
individual(s) seeking employment with your company.- Fname Lname
- Fname Lname
- Fname Lname
C. REQUEST OPTIONS
- Please be mindful of our staff's time and only mark the required checkboxes for the performance of your duties; for example, if no amount of citations can affect employment, do not mark the citation box.
B.1 - Timeframe:
Mark only one box by changing [cb] to [cbc]
- One week
Two weeks
Three weeks
Mark up to three boxes by changing [cb] to [cbc]
- Citations
Misdemeanors
Felonies
- One week
D. ACKNOWLEDGEMENT
- I, the undersigned, affirm under penalty of forgery, that all information provided above is accurate, to the best of my knowledge. I affirm that my employer is aware of me submitting this request, and allows it as per internal guidelines or direct order. I affirm that all of the individuals listed in section B are aware that a background check is being performed on them, and that they have consented to this.
C1. Signature: Cole Hamilton
C2. Date Signed: 29/JUNE/2025



POLICE COMMANDER