Form 212A is used exclusively for the purpose of local Police Department and State
Agencies, to obtain background information for the purposes of employment, licensing
and local ordinances.
The Originating Agency Identifier (ORI) is a unique number assigned to each Police
Department and State Agency. It's a way to identify who made the request and where
the response should be returned. The form will be rejected if the ORI is not correct
or not indicated. There are no refunds for rejected form.
Please verify the ORI with the Police Department or State Agency before submitting