Step 1: Open the PDF Editor
Click the "Get Form Here" button to open the LCLB004 criminal history form in FormsPal's free browser-based editor. The form loads immediately. No downloads, no software, and no account are required to get started.
Step 2: Enter Your Personal and Residency Details
Start by answering the permanent resident questions at the top of the form. Attach a copy of your residency documentation if required. Then complete the residency and out-of-province fields. If you currently hold or have held any liquor licenses, fill in those details. Complete the Rural Agent section if it applies to your situation. Use additional sheets if you need more space for any answer.
Fields to complete in this section include:
- Permanent resident status and supporting documentation
- Out-of-province statutory declaration if applicable
- Current and past liquor license details including license type and location
- Rural Licensee Agent information if relevant
Step 3: Disclose Business Agreements and Financial History
Answer all questions about agreements that could affect your licensed establishment. Declare any family involvement in liquor businesses. Report any contractual arrangements with liquor suppliers or distributors. Answer the financial record questions honestly and completely. Add extra sheets where needed.
Key disclosures in this section:
- Any agreements with current license holders that affect your business
- Immediate family members involved in liquor businesses
- Contractual obligations with liquor manufacturers or agencies
- Any pending or past receivership or bankruptcy proceedings
Step 4: Disclose Criminal Record and Driving History
List all criminal charges and convictions in this section. Include both Canadian and international offenses. For each offense, provide the type, date, location, and final outcome. For driving infractions, you must attach a copy of your current driving abstract. Include certified copies of court documents where required by the LCLB.
Step 5: Sign the Declaration and Authorization
Read the Declaration and Authorization section carefully before signing. Your signature authorizes the Royal Canadian Mounted Police to conduct a criminal record check on your behalf. It also confirms that all information you provided is accurate and complete. Print your name, sign, and include the date. Attach a legible colour photograph or photo ID as required.
Step 6: Save, Download, and Submit
Click the "Done" button when you finish. Your completed form is ready for download. Save it to your device or send it by email. Print at least two copies before submitting. Keep one copy for your personal records and submit the other to the LCLB Head Office along with your full application package.
Frequently Asked Questions
What is this criminal history consent form?
It is the LCLB004 Personal History Summary and Consent to Criminal Record Search form. The Liquor Control and Licensing Branch in British Columbia uses it to screen license and permit applicants through an RCMP criminal background check.
Who is required to complete this form?
Anyone applying for a liquor primary license, food primary license, manufacturer permit, or agency authorization in British Columbia must complete this form. New owners, directors, and partners added to existing licenses also need to submit it.
Can I fill out this form online?
Yes. FormsPal provides a free browser-based PDF editor. No software installation is needed. Fill out the form, download it, print it, and sign it before submission.
What should I submit along with this form?
Submit the signed form with your main liquor license application package to the LCLB Head Office. Include a legible colour photo ID. Attach a driving abstract and any court documents if you disclosed offenses on the form.
Where can I find related law enforcement and licensing forms?
FormsPal offers a wide range of related documents. For law enforcement purposes, see our printable police report form or police verification report. For incident documentation, try the incident offense report or the clinical incident report sample. For background checks, use our background check consent form.
