N O T I C E

THE PENNSYLVANIA STATE POLICE CENTRAL REPOSITORY LOCATED AT 1800
ELMERTON AVE, HARRISBURG, PENNSYLVANIA 17109, MAINTAINS CRIMINAL HISTORY
RECORD INFORMATION ON ALL INDIVIDUALS WHO HAVE BEEN ARRESTED FOR A CRIME
AND SUBSEQUENTLY FINGERPRINTED AS A RESULT OF SUCH ARREST.

CRIMINAL HISTORY RECORD INFORMATION IS MAINTAINED TO PROVIDE CRIMINAL
JUSTICE AGENCIES AND OTHER INTERESTED PERSONS WITH A CHRONOLOGICAL LISTING
OF PAST CRIMINAL BEHAVIOR OF PERSONS FINGERPRINTED AS A RESULT OF AN ARREST.

CRIMINAL HISTORY RECORD INFORMATION IS USED BY CRIMINAL JUSTICE AGENCIES
AS AN INVESTIGATIVE AID IN CRIMINAL INVESTIGATIONS.

CRIMINAL HISTORY RECORD INFORMATION MAY BE USED BY EMPLOYERS IN
DETERMINING THE SUITABILITY OF APPLICANTS.

CRIMINAL HISTORY RECORD INFORMATION MAY BE USED BY BOARDS, COMMISSIONS
OR DEPARTMENTS OF THE COMMONWEALTH AUTHORIZED TO LICENSE, CERTIFY, REGISTER
OR PERMIT THE PRACTICE OF TRADES, OCCUPATIONS OR PROFESSIONS.

CRIMINAL HISTORY RECORD INFORMATION MAY ALSO BE REVIEWED BY THE
SUBJECT OF SUCH INFORMATION TO DETERMINE COMPLETENESS AND ACCURACY.

TO OBTAIN A COPY OF CRIMINAL HISTORY RECORD INFORMATION MAINTAINED BY
THE PENNSYLVANIA STATE POLICE CENTRAL REPOSITORY YOU MUST:

1. COMPLETE FORM (SP 4-164) REQUEST FOR CRIMINAL HISTORY
   RECORD INFORMATION, IN DUPLICATE, ACCORDING TO
   INSTRUCTIONS ON REVERSE SIDE OF THE FORM
2. ATTACH A CHECK OR MONEY ORDER IN THE AMOUNT OF
   TEN DOLLARS ($10.00) PAYABLE TO
   COMMONWEALTH OF PENNSYLVANIA
   WHEN THE REQUEST IS MADE BY A NON CRIMINAL JUSTICE
   AGENCY OR INDIVIDUAL.