Criminal History bRecordb Request bFormb - Nebraska State Patrol - statepatrol nebraska 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the date of your request at the top of the form.
3. Indicate whether this request is for yourself or someone else by checking the appropriate box.
4. Fill in the personal details of the person of interest, including first name, middle name, last name, and any aliases they may have used.
5. Provide the Social Security Number (SSN) and date of birth (DOB) in the specified formats. Note that providing an SSN is optional but may expedite processing.
6. Complete the current address section with city, state, and zip code, along with a contact phone number.
7. If applicable, fill out the section for individual or agency requesting the background check if different from above.
8. Sign and date where indicated. If notarization is required, ensure that it is completed before submission.

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