State Of Iowa Dhs Criminal History Record Check Form B
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2Iowa Department of Human Services
Terry E. Branstad
Kim Reynolds
Charles M. Palmer
Governor
Lt. Governor
Director
Please attach this statement to Form 595-1396, Record Check Form B and have the
applicant review prior to signing Form B:
Evaluation of Deferred Judgments
All deferred judgments, whether discharged or not, shall be subject to the record check
review/evaluation process, as they are considered to be convictions.
Child Care Licensing
1305 E. Walnut Street, Des Moines, IA 50319-0114
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