Request for a Criminal History Record Information for a Noncriminal Justice Purposes

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Please fill out all information below to register an account with the New Jersey Criminal History Record Request - Name Check (212B) service.

Requestor Details

First Name * *
Last Name * *
Business Name
Email Address * Email Address is not valid * Email ids do not match
Confirm Email Address * * Email ids do not match
Phone * * Ext
Address can be a US or International address. Enter a US Address Enter an International Address

Street Address1 * *
Street Address2 *
City * *

State * State Required
Zip Code * - Zip Required

Province *
Country * Country Required
Postal Code *

Complete All Required Fields [ * ]

User Details

First Name **
Last Name **
Business/Company Name **
Email Address ***
Confirm Email Address ***
Telephone Number*

Example: xxx-xxx-xxxx

New Jersey State Police

P.O. Box 7068

West Trenton, NJ 08628

609-882-2000

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