Submit this completed form to New York City DOE Division of Human Capital by using the HR Connect Web Portal.
Who files it: individuals who have been previously fingerprinted (after July 1, 1990) for a license and/or employment by the New York City Board of Education (NYCBOE).
They are authorizing: the NYCBOE to forward their criminal history to the New York State Education Department for certification application and/or employment purposes.
Section 1: inaccurate or incomplete information will delay processing.
Upload page: all fields on the Upload Document page must be completed to submit your form.
Subject field: enter in the Subject field OSPRA 104 form.
| Question | Answer |
|---|---|
| Form Name | OSPRA 104 |
| Form Length | 1 page |
| Fillable? | Yes |
| Fillable fields | 15 |
| Avg. time to fill out | 3 min |
| Edition | 09/23 |
| Issuing agency | Office of School Personnel Review and Accountability NYS Education Department |
| Where to send | HR Connect Web Portal, NYC DOE Division of Human Capital |
| Other names | OSPRA 104, OSPRA104, OSPRA 104 form, OSPRA form, NYSED OSPRA 104, Authorization to Forward Criminal History Record Information |
| Official source | OSPRA 104 (Rev 09/23), Office of School Personnel Review and Accountability |
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