Rome, GA · Floyd County
Criminal History Consent Form
This form lets a person authorize the Rome Police Department to obtain their criminal history for a stated purpose, such as employment.
What this form is
The form authorizes the Rome Police Department to request criminal history information from the Georgia and national criminal information files. It asks for identifying details, the purpose code, the recipient, and the signer’s consent; it also offers options for limited-duration authorization or periodic checks during employment.
Who needs it
A person asked to authorize a criminal history check through the Rome Police Department for employment or another listed purpose should complete this form.
How to submit it
The form names the Rome Police Department at 375 Technology Parkway NW, Rome, Georgia 30161. It says the original is placed in agency files and a copy with raised seal goes to the requestor.
About notarization
No notary is required; the form includes a notary line for signatures not made in the presence of Rome Police Department personnel, and the signer dates it.
How to submit this form
- 1
Download The Form
Download the Criminal History Consent Form PDF.
- 2
Complete The Form
Print your identifying details, select a purpose code, name the recipient, and complete the consent and signature fields.
- 3
Review The Authorization
Choose the stated authorization duration or indicate consent for periodic checks during employment, as applicable.
- 4
Submit To The Police Department
Use the Rome Police Department address printed on the form. The original is placed in agency files, and a copy with raised seal goes to the requestor.
Frequently asked questions
- What does the Criminal History Consent Form authorize?
- It authorizes the Rome Police Department to receive criminal history information from the Georgia and national criminal information files for the purpose selected on the form.
- Who completes this form?
- The person whose criminal history is requested provides identifying details and consent. The form includes purpose codes for employment, public records, and other listed uses.
- Do I need a notary for the Criminal History Consent Form?
- No notary is required. The form has a notary line for signatures not made in the presence of Rome Police Department personnel; the signer dates the form.
- How do I submit the Criminal History Consent Form?
- The form lists the Rome Police Department at 375 Technology Parkway NW, Rome, Georgia 30161. It says the original goes in agency files and a copy with raised seal goes to the requestor.
Need something notarized?
This Criminal History Consent Form doesn’t need a notary — but if you have another Rome form that does, a commissioned online notary can help.