Drivers Permit Application (Page 4 of 4) in pdf

DPS Computerized Criminal History (CCH) Verification

(City of Arlington Copy)

I, ______________________________________, have been notified that a Computerized Criminal

APPLICANT NAME (Please print)

History (CCH) verification check will be performed by accessing the Texas Department of Public Safety Secure

Website and will be based on name and DOB identifiers I supply.

Because the name-based information is not an exact search and only fingerprint record searches

represent true identification to criminal history, the organization conducting the criminal history check for

background screening is not allowed to discuss any criminal history record information obtained using the

name and DOB method. Therefore, the City of Arlington may request that I have a fingerprint search

performed to clear any misidentification based on the result of the name and DOB search.

For the fingerprinting process I will be required to submit a full and complete set of my fingerprints for

analysis through the Texas Department of Public Safety AFIS (Automated Fingerprint Identification System). I

have been made aware that in order to complete this process I must make an appointment with L1 Enrollment

Services, submit a full and complete set of my fingerprints, request a copy be sent to the City of Arlington, and

pay a fee of $24.95 to the fingerprinting services company, L1 Enrollment Services.

Once this process is completed and the City of Arlington receives data from DPS, the information on

my fingerprint criminal history record may be discussed with me.

Signature of Applicant

FOR OFFICE USE ONLY:

Purpose of CCH:

Pedicab Operator and Driver Permitting

Date

CCH Report Printed:

Yes ___ NO___

_______Initial

City of Arlington Representative Name (Please Print)

Date Printed______________

_______Initial

Permitted___ Not Permitted___

_______Initial

Signature of City of Arlington Representative

Destroy Date______________

_______Initial

Date

This copy must remain on file with the City of Arlington and be used for future DPS auditing purposes.

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Drivers Permit Application Page 4