Fillable Police Records Check Form (Page 2 of 2) in pdf

POLICE RECORDS CHECK RELEASE CRITERIA

The Police Vulnerable Sector Check will include the following information

The search does NOT cover the following areas:

as it exists on the date of the search:

•

Convictions under provincial statutes.

•

Criminal Convictions from CPIC and/or local databases.

•

Local Police Contact.

•

Outstanding entries, such as charges and warrants, Judicial Orders,

•

Ministry of Transportation Information (PARIS).

Peace Bonds, Probation and Prohibition Orders.

•

Special Interest Police (SIP) category of CPIC.

•

Summary Convictions, for 5 years, when identified.

•

Family Court Restraining Orders.

•

Absolute and Conditional Discharges for 1 or 3 years respectively.

•

Foreign Information.

•

Findings of Guilt under the Youth Criminal Justice Act within

the applicable disclosure period.

•

Any reference to incidents involving mental health contact.

•

Criminal charges resulting in a disposition of Not Criminally

•

Notable police contact that were processed by other means,

Responsible by Reason of Mental Disorder.

such as Diversion.

•

All Records Suspension as authorized for release by the Minister

•

Youth Criminal Justice Act information beyond the applicable

of Public Safety.

disclosure period.

•

In very exceptional cases, where it meets the Exceptional Disclosure

•

Any reference to contagious diseases.

Assessment, non-conviction dispositions, including, but not limited

to Withdrawn and Dismissed.

This search is intended for individuals seeking employment and/or a volunteer position with children or vulnerable person(s). Information

is collected and disclosed according to section 29(1) and 32 of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA)

and the Police Services Act, RSO 1990,c.P.15

The information contained on this certificate is accurate on the date issued.

For more information, please visit our Web site at ottawapolice.ca

PROCEDURE

The Police Records Check Form must not be altered.

The applicant must apply in person and produce two pieces of valid (i.e. not expired) identification that confirm his/her name, date of birth

and address. One piece of identification presented must include a photo. Ontario Health Cards cannot be accepted for identification purposes

(Health Cards and Numbers ControlAct, 1991 section 2.2(1)).

In the case of a possible match, individuals who require a copy of their criminal record, will have to be fingerprinted by the Ottawa Police Service.

Please see the attached information sheet and or visit our website for further information at

VOID without Ottawa Police seal

First Name:

Middle Name:

Surname:

Date of Birth (yy/mm/dd):

FOR POLICE USE ONLY

This is to confirm that no criminal convictions, no outstanding

This is to notify that there are current/active Judicial Orders

charges, no outstanding judicial orders, no pardoned sex offences

associated to the above name and date of birth. Please see the

have been found in the Canadian National Repository of Criminal

attached Disclosure document.

Records as a result of a search based on the above name and

Please SEE ATTACHED DISCLOSURE document.

date of birth. The search has not been confirmed by fingerprints.

This is to notify that there are Non-Conviction Records for

This is to notify that there may be criminal convictions,

Exceptional Disclosure associated to the above name and date

outstanding charges, or pardoned sex offences associated to

of birth. The information meets the Exceptional Disclosure

the above name and date of birth. The existence of which may

Assessment and is being released under the authority of PSA

only be confirmed by the RCMP based on fingerprints.

(265.98, S.3).

Please SEE ATTACHED DISCLOSURE document.

Date Completed (yy/mm/dd):

Signed:

(BY POLICE)

POLICE AUTHORIZING SIGNATURE

For more information, please visit our Web site at ottawapolice.ca

Police Records Check Form Page 2

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