FBI I-783 PDF Details

This summary form includes a person's criminal history records and is often used for reviewing, changing, correcting, or updating the information on the summary. It is important to note that this is not a national background check and may not include information from state repositories that would be included in an employment background check.

The form requires you to provide personal information such as your name, date of birth, place of birth, citizenship status, social security number, race, sex, and contact information. It also requires the requester's signature and a payment of $18 (in the form of a certified check, money order, or credit card) to process the request.

The form also includes a Privacy Act Statement, which explains the legal basis for collecting the information and the possible uses and disclosures of the information provided. Additionally, there is a Paperwork Reduction Act Statement, which indicates that the form takes approximately 3 minutes to complete and that it is required to have a valid OMB control number.

QuestionAnswer
Form NameFBI I-783 Form
Form Length1 pages
Fillable?Yes
Fillable fields31
Avg. time to fill out6 min 31 sec
Other namesform i 783 instructions, i 783 form, fbi clearance form application, form i 783

Form Preview Example

1-783 (Rev. 06-01-2020)

OMB-1110-0052

IDENTITY HISTORY SUMMARY REQUEST FORM

Information * Denotes Required Fields

*Last Name

Middle Name 1

*First Name

Middle Name 2

 

*Date of Birth:

*Place of Birth:

 

*U.S. Citizen or Legal Permanent Resident:

 

 

 

 

 

Yes

No

 

 

 

 

 

 

 

 

*Country of Citizenship:

Country of Residence:

 

Prisoner Number (if applicable):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Last Four Digits of Social Security Number:

*Race (please check appropriate box):

Asian

Black

Caucasian

Native American

Unknown

*Sex (please check appropriate box):

Male Female Other

Address

C/O

*Address

ATTN

 

 

 

 

 

 

 

 

 

 

 

*City

 

 

 

*State

 

 

 

 

 

 

 

 

 

 

 

 

 

*Postal (Zip) Code

 

*Country

 

 

 

Phone Number

 

E-Mail

 

 

 

 

 

 

Payment Enclosed: (please check appropriate box)

CERTIFIED CHECK

MONEY ORDER

CREDIT CARD FORM

You may request a copy of your own Identity History Summary to review it or obtain a change, correction, or an update to the summary. This is not a national background check and may not include information from state repositories which would be included on an employment background check. If you are requesting a background check for employment or licensing within the U.S., you may be required by state statute or federal law to submit your request through your state identification bureau, the requesting federal agency, or another authorized channeling agency.

* REQUESTOR SIGNATURE

DATE____________________

Mail the signed requestor information form, fingerprint card, and payment of $18 U.S. dollars to the following address:

FBI CJIS Division – Summary Request

1000 Custer Hollow Road

Clarksburg, West Virginia 26306

PRIVACY ACT STATEMENT

The FBI’s acquisition, retention, and sharing of information submitted on this form is generally authorized under 28 USC 534 and 28 CFR 16.30-16.34. The purpose for requesting this information from you is to provide the FBI with a minimum of identifying data to permit an accurate and timely search of FBI identification records. Providing this information (including your Social Security Account Number) is voluntary; however, failure to provide the information may affect the completion of your request. The information reported on this form may be disclosed pursuant to your consent and may also be disclosed by the FBI without your consent pursuant to the Privacy Act of 1974 and all applicable routine uses.

PAPERWORK REDUCTION ACT STATEMENT:

Under the Paperwork Reduction Act, you are not required to complete this form unless it contains a valid OMB control number. The form takes approximately 3 minutes to complete.

How to Edit FBI I-783 Form Online for Free

Our PDF editor allows you to manage the information form fbi document. It will be easy to make the document right away by using these simple actions.

Step 1: The first step requires you to hit the orange "Get Form Now" button.

Step 2: Now you are on the form editing page. You may enhance and add text to the document, highlight words and phrases, cross or check specific words, add images, sign it, get rid of needless fields, or eliminate them entirely.

The PDF document you are going to prepare will include the following areas:

entering details in applicant information stage 1

Add the requested particulars in the City Postal Zip Code Phone Number, State Country EMail, Payment Enclosed please check, CERTIFIED CHECK, MONEY ORDER, CREDIT CARD FORM, You may request a copy of your own, REQUESTOR SIGNATURE DATE, Mail the signed requestor, FBI CJIS Division Summary Request, and PRIVACY ACT STATEMENT The FBIs section.

applicant information City Postal Zip Code Phone Number, State Country EMail, Payment Enclosed please check, CERTIFIED CHECK, MONEY ORDER, CREDIT CARD FORM, You may request a copy of your own, REQUESTOR SIGNATURE DATE, Mail the signed requestor, FBI CJIS Division Summary Request, and PRIVACY ACT STATEMENT The FBIs fields to fill

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