ABC City/County/Township Portal
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Request for Background Check
Please complete this form and pay the required fees to get this request processed.
Agency Requesting
Name for Search
SSN
DOB
(mm-dd-yyyy)
Court Case Number
FBI/ISP Number
Date of Arrest
(mm-dd-yyyy)
Person Requesting Name
Address
City
State
Phone Number
Fax
E-mail Address
Best Time and Way to Contact You
Comments
Once your record is located, we will contact you to determine how you would like to obtain it and provide payment. Thank you!
Fees:
Certified Record: $2/document
Faxed Document: $2/page
Mailed Document: $2/document
Court Record: $1/page
Attach Document (PDF, JPG, PNG, GIF, TIFF Only)
Enter the code here
Thank You
