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  1. Click ‘Get Form’ to open the sp 4 164 form in the editor.
  2. Begin by filling in your name in the 'Requester Name' field. Ensure that it is legible, as illegible forms will be returned unprocessed.
  3. Enter your complete address, including city, state, and ZIP code. This information is crucial for mailing the response back to you.
  4. Provide your telephone number in the designated area. This allows for any necessary follow-up regarding your request.
  5. Select the appropriate fee option by checking one of the boxes provided. Remember to include a certified check or money order as specified.
  6. Fill out the 'Subject of Record Check' section with the individual's first, middle, and last names, along with their social security number and date of birth.
  7. Indicate the reason for your request by checking the relevant box. This helps streamline processing based on your needs.
  8. Once all fields are completed accurately, save your document and follow instructions for submission via mail to ensure timely processing.

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For additional information on obtaining or renewing clearances, please contact the Human Resources office. Fees for obtaining these clearances are as follows: PA Child Abuse $13.00. PA Criminal History $22.00.
The process can be expedited by applying online at . Complete your clearance application online using a credit card for a cost of $22. You are responsible for this cost.
It may take up to two weeks for the status to be updated from a Request Under Review to a No Record or Record. PATCH accepts both Registered and Non-Registered Users. REGISTERED USERS: Companies, agencies, or offices that routinely have a need to make criminal record checks.

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