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Click ‘Get Form’ to open the ASP-122 in the editor.
Begin by filling in your full name, including first, middle, last, and maiden names. Ensure accuracy as this information is crucial for identification.
Enter your date of birth in the format Month/Day/Year, along with your state of birth, race, and sex.
Provide your Social Security number and Driver’s License number along with the issuing state.
Complete your mailing address including street, city, state, and ZIP code. This is where any correspondence will be sent.
Fill in your daytime phone number for any follow-up communication regarding your request.
Sign the form to give consent for a criminal record search. Remember that a notarized signature is required if submitting by mail.
If applicable, include a check or money order for $25 made payable to the Arkansas State Police and ensure you have a self-addressed envelope ready for mailing.
Start using our platform today to fill out the ASP-122 form easily and efficiently!
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How long does a background check take in Arkansas?
Get a Copy of Your Criminal Record You can ask for a copy of your official criminal record from the State of Arkansas. Find the request form online at acic.org.
Can a convicted felon be a CNA?
In some cases, those with a criminal history of some sort may still be eligible for CNA certificationas their state nursing board will review said history and make a decision based on various factors (e.g., the nature of the offense, passage of time since the offense occurred, evidence of rehabilitation or positive
Can a felon be a caregiver in Arkansas?
(A) A caregiver or applicant to become a caregiver who has pleaded guilty or nolo contendere to or has been found guilty of a felony or crime involving moral turpitude or dishonesty shall not be employed to provide services paid with Medicaid funds.
What can felons not do in Arkansas?
In Arkansas, individuals convicted of a felony may lose their right to vote, possess firearms, serve on a jury, or hold public office. These restrictions can have a lasting impact on an individuals ability to fully participate in society.
Can you be a CNA with a felony in Arkansas?
(1) Upon receipt of a proper request from a volunteer organization, the Identification Bureau of the Department of Arkansas State Police shall conduct a background check through the Arkansas Crime Information Center.
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
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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