New York State Office Of Court Administration Record Search For Conviction Of Prosecution And Pending Page 4

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Instructions for completing the New York State, Office of Court Administration's
Criminal History Record Search (CHRS) Application
NEW YORK STATE OFFICE OF COURT ADMINISTRATION RECORD SEARCH FOR CONVICTION OF PROSECUTION AND PENDING
Rev 5/07
1
Customer is required to complete
this section.
NY STATEWIDE SEARCH
OFFICIAL USE ONLY
PHILIP J. ANDERSON
NAME / COMPANY:
120-35 73
RD
AVENUE
STREET ADDRESS:
PAGE :
OF
2
Specify number of pages, date
3
3
1
FOREST HILLS, NY 11357
CITY, STATE, ZIP
1
2
2
submitted, and if you prefer the
:
DATE
E- MAIL
MAIL
PICKUP
results of the search emailed or
(718)275-0665 / (718)275-0655
TELE./FAX NUMBER:
returned to you by mail (if by mail,
PANDERSON@CRIMSEARCH.NET
CONTACT/ EMAIL ADD.
include a self addressed stamped
NO
LAST NAME
FIRST NAME
SUFFIX
DOB
FOR YOUR USE
envelope), or picked up.
(TYPE OR PRINT IN CAPITALS)
(TYPE OR PRINT IN CAPITALS)
MM/DD/YYYY
1
MILLER
JOHN
JR.
02/09/1951
3
Receipt information is stamped on
2
LEWIS
SHERRY
06/25/1980
the upper right hand corner showing
date of request and job number.
3
MITCHELL
ROBERT
4
III
12/10/1964
4
Phone inquiries regarding your
4
BLAND
JOSE
10/03/1975
CHRS request status can be
5
5
expedited if you have the Job
5
Number available.
6
4
Print (clearly) or type the required
information in each column - Last
7
Name, First Name, do not include
8
Middle Initial, Suffix (e.g.,Jr., III),
and Date of Birth. The blank
9
column is for future use. Please
note the search mechanism is
10
based on finding an exact match of
Email Address: Provide your email address if you like search results emailed to you
the Name and DOB submitted.
Statewide Search: The electronic statewide search includes all 62 counties of the State of New York
Inquiries regarding criminal disposition data should be directed to OCA’s Criminal History Record Search Unit at (212)428-2943 between the hours of 9:30 and 4:30 pm. Requests for additional copies
of the Criminal History Record Search application can be made to OCA’s CHRS Intake Unit at (212) 428-2810 or you can download the form from the New York State Court’s website
:
5
This section is provided for
customer use.
NOTE: See FAQ’s “Frequently Asked Questions” on page 2.

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