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ASP-122 Individual Record Check Request Form
When an Arkansas background check is requested, include a properly completed ASP-122 request form; a check or money order in the amount of $25.00,.
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ARKANSAS STATE POLICE
The ASP form 122, Individual Record Check Form, must be completed in its entirety. 2. A check or money order in the amount of $10.00 for volunteers made
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4-H Arkansas State Police Form
ASP 122VOL. (Eff. 02/19/2019). First Name. Middle Name. Jr./Sr./III. Daytime Phone #:. List ALL other names ever used (married, maiden, shortened, etc.) Date of
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