If the Examination Bulletin requires this Criminal Record Supplemental Questionnaire to be submitted with your application, you must complete all sections.
Question 1: have you ever been convicted by any court of a misdemeanor crime of domestic violence?
Question 2: have you ever been convicted by any court of a felony?
Questions 1 and 2: answer these questions only if required on the Examination Bulletin.
Easy ID: if you are unable to determine your Easy ID, leave it blank.
Explanations: use this section to explain the details of any response that requires additional information.
Signature: your signature and the date signed is required.
| Question | Answer |
|---|---|
| Form Name | CalHR 884 |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 20 |
| Avg. time to fill out | 4 min |
| Edition | Rev 11/2016 |
| Issuing agency | California Department of Human Resources |
| Matches the agency's file | Yes, checked October 7, 2026 |
| Other names | CalHR 884, CalHR884, Criminal Record Supplemental Questionnaire, Criminal Record Questionnaire |
| Form usage | California state employment examination applications |
| Official source | CalHR 884 (Rev 11/2016), California Department of Human Resources |
Criminal Record Supplemental Form isn’t the one you’re looking for?