Criminal record check: ar920100z - Arkansas Department of Human - humanservices arkansas 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling in the 'Facility/License #' section at the top. This identifies your facility and is crucial for processing your request.
3. In the 'Facility Requesting Report' field, enter the name of your facility. Follow this by providing the name of the Licensing Specialist requesting the check.
4. Complete the mailing address fields, including city, state, and zip code. Ensure accuracy to avoid delays.
5. Fill in your telephone number and that of the Facility Director. This information is essential for communication regarding your request.
6. For the person being checked, provide their full name, date of birth, social security number, and driver's license or government ID number.
7. Indicate if they have lived in Arkansas for the past five years and complete their physical address.
8. Answer whether they have ever been found guilty of a crime. If yes, attach a detailed description as required.
9. Finally, ensure that the person being checked signs and dates the form before submission.

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