Form Ncic Check PDF Details

The NCIC Check form, officially known as BP-A660.012 from the U.S. Department of Justice Federal Bureau of Prisons, plays a crucial role in ensuring the safety and integrity of federal prison environments. It serves as an Authorization for Release of Information specifically geared towards conducting a thorough National Crime Information Center (NCIC) background investigation. By completing this form, individuals seeking to enter, volunteer, or serve a contract at any Bureau facility consent to have their criminal history meticulously reviewed. The form requires a comprehensive list of personal information, including but not limited to, name, address, social security number, citizenship, and physical characteristics. This detailed information collection process underscores the gravity with which the Bureau of Prisons approaches the vetting of individuals entering its facilities. The NCIC check is a mandatory step, and failure to provide the requested data may not only lead to denial of entry but could also affect one’s volunteer or contract status with the Bureau. Additionally, the form incorporates a Privacy Act Notice that explains the authority under which the information is collected, the purpose and use of the data obtained, and the potential consequences of non-disclosure. This meticulously structured process is designed to protect both the individuals inside the Bureau facilities and uphold the integrity of the Federal Prison system by ensuring that everyone entering the premises has undergone a comprehensive background check.

QuestionAnswer
Form NameForm Ncic Check
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
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BP-A660.012

NCIC CHECK CDFRM

MAR 99

 

 

U.S. DEPARTMENT OF JUSTICE

FEDERAL BUREAU OF PRISONS

 

 

 

 

 

 

AUTHORIZATION FOR RELEASE OF INFORMATION

NCIC (National Crime Information Center) CHECK

I hereby authorize a representative of the Federal Bureau of Prisons to obtain any information on my criminal history background. I understand that this check must be done before I am allowed to enter/serve at any Bureau facility. I also understand that refusal to provide all necessary information may result in 1) denial of entry into a Bureau facility and 2) denial of volunteer/contract status.

1.Name (Last, First, Middle)

2.Address (Street address) (City, State, County, Zip Code)

3.Home Telephone Number (Area Code, Number):

4.Aliases/Nickname:

5.Citizenship (List the country you are a citizen of):

6.Social Security Number:

7.Date of Birth (Month, day, year):

8a.

Sex:

8b.

Race:

 

 

 

 

 

8c.

Height:

8d.

Weight:

 

 

 

 

 

8e.

Color of Eyes:

9f.

Color

of Hair:

 

 

 

 

 

9.Place of Birth (City, State, County), (List city, county and country if outside the U.S.A)

10.The above listed information is true and correct. Applicant’s Signature

10a. Date

PRIVACY ACT NOTICE

Authority for Collecting Information: E.O. 10450; 5 USC 1303-1305; 42 USC 2165 and 2455; 22 USC 2585 and 2519; and 5 USC 3301

Purposes and Uses: Information provided on this form will be furnished to individuals in order to obtain information regarding activities in connection with an investigation to determine (1) fitness for Federal employment, (2) clearance to perform contractual service for the Federal Government, (3) security clearance or access. The information obtained may be furnished to third parties as necessary in the fulfillment of official responsibilities.

Effects of Non-disclosures: Furnishing the requested information is voluntary, but failure to provide all or of part the information may result in lack of further consideration for employment, clearance or access, or in the termination of your employment.

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1. Whenever filling in the ncic fom, be certain to complete all of the important blanks within the corresponding section. It will help expedite the process, which allows your information to be handled swiftly and properly.

Filling in segment 1 in form ncic check

2. The subsequent part is to complete the next few fields: The above listed information is, a Date, P R I V A C Y A C T N O T I C E, Authority for Collecting, Purposes and Uses Information, and Effects of Nondisclosures.

Find out how to prepare form ncic check part 2

Always be extremely mindful when completing Authority for Collecting and Effects of Nondisclosures, because this is where most users make mistakes.

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