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(For official use only, not to be released to unauthorized persons)

(For official use only, not to be released to unauthorized persons) 2025

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The document is an authorization form from the Wisconsin Department of Safety and Professional Services, allowing the department to obtain FBI criminal history records based on submitted fingerprints. It outlines the privacy statement, procedures for challenging inaccuracies in the records, and the implications of providing personal information. The form is intended for individuals applying for various professional licenses and includes instructions for completing the application.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your last name, first name, and middle initial in the designated fields. Ensure accuracy as this information is crucial for identification.
Select your race and sex from the provided options. This information is required for the criminal background check.
If applicable, enter your Wisconsin License Number and any former or maiden names you may have used.
Fill in your date of birth in the specified format (MM/DD/YYYY).
Provide your current address including street, city, state, and zip code.
Sign and date the form at the bottom to confirm that all information provided is accurate.
For specific licenses like Wholesale Distributor of Prescription Drugs, ensure you complete additional fields such as DBA Name and Facility’s Address.

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Versions	Form popularity	Fillable & printable
2021	4.8 Satisfied (67 Votes)
2018	4.4 Satisfied (203 Votes)
2018	4.2 Satisfied (26 Votes)
2014	3.9 Satisfied (44 Votes)

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What is an example of for official use only?

For Official Use Only (FOUO): This label is used across various government agencies to mark unclassified information that isnt yet approved for public release. Like LES, FOUO information requires protection but applies more broadly across all government agencies.

What does for official use only mean?

Mark the records ``For Official Use Only, and tell the recipient the information is exempt from public disclosure under the FOIA and whether it needs special handling.

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