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{Report Date} {4-Digit Num}
{Name}
{Address}
The Criminal Justice Information Services (CJIS) Division of the Federal Bureau of Investigation has completed the following submission:
(This is in table form, that I cannot replicate here)
Subject Name -> {Name}
Search Completed -> {Search Completed Date}
Result -> A search of the fingerprint provided by this individual has revealed no prior arrest data at the FBI, this does not preclude Further criminality history at the state and local level.
Social Security Number: XXX-XX-{Last 4 Digits of SSN}
The result of the above response is only effective for the date the submission was originally completed. For more updated information, please submit new fingerprints of the subject.
In order to protect Personally Identifiable Information, as of August 17, 2009, FBI policy has changed to no longer return the fingerprint cards. This form will serve as FBI's official response.
Any questions may be addressed to the Customer Service Group at (304) 625-5590. You may also visit the Web site at www.fbi.gov for further instructions.
This Criminal History Record Information (CHRI) is provided pursuant to 28 CFR 16.30-16.34 solely for you to conduct a personal review and/or obtain a change, correction, or updating of your record. This CHRI is not provided for the purpose of licensing or employment or any other purpose enumerated in 28 CFR 20.33.
CJIS Signature
DOJ/FBI Seal
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