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cori request form The Norton Public Schools is registered under the provision of M.G.L. c.6, §172 and is certified by the Criminal History Systems Board for access to all criminal case data including conviction, non-conviction and

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superintendent of schools swansea, ma 02777 assistant superintendent (508) 675-1195 fax (508) 672-1040 criminal offender record information (cori) acknowledgement form to be used by organizations conducting cori checks for employment, volunteer, subcontractor, licensing, and housing purposes

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Plymouth, Massachusetts 02360 FAX (508) 830-4140 PLYCC G CORI REQUEST FORM Plymouth Board of Selectmen has been certified by the Criminal History Systems Board for access to conviction and pending criminal case data. As an applicant for a Pawn Broker license, I understand that a criminal record check will be conducted for ...

opportunity to include this information to ensure the accuracy of the CORI request process. All CORI request forms that included this field are required to be submitted to the CHSB via mail or by fax to 617-660-4614. CORI REQUEST FORM Criminal Offender Record Information APPLICANT INFORMATION First Name Middle Name Last Name Suffix (Jr., Sr. III, etc.) Former Last Name Former Last Name 2 Former Last Name 3 XXX-____ ____ - ____ ____ ____ ____ Date of Birth Place of Birth (City/Town) Social Security Number (Last 6 digits) ...