What does the criminal record search request form ask for?

It asks for the requester’s contact information, the searched person’s name and required date of birth, the time period to search, and optional identifying details.

How much does a criminal record search cost?

The form states a fee of $5 for each name searched for every two-year period or portion thereof. If an indictment number is provided, it says the fee is $5 for a Certificate of Conviction, with no search fee.

How do I submit the criminal record search request?

Send the completed form to the Chenango County Clerk’s Office at 5 Court Street, Norwich, NY 13815. The form says checks are payable to Chenango County Clerk.

Do I need a notary for the criminal record search request?

No. This form is signed and dated without a notary, and it mentions no notarized or sworn attachment.

Chenango County, NY · Chenango County

No notary required

Request for Criminal Record Search

This form lets a person request a criminal history search from the Chenango County Clerk’s Office and provide details about the person to be searched.

At a glance

Issued by: City of Chenango County · Chenango County, Chenango County, New York
Notarization: Not required: file this form without a notary.
Official source: chenangocountyny.gov
Blank form: Download the PDF
Catalogued: Oct 5, 2026
Machine-readable: JSON record · about the forms index

What this form is

Use this form to ask the Chenango County Clerk’s Office to search criminal records it maintains and provide written information about a named person. It requests the requester’s contact information, the searched person’s name and required date of birth, and the time period to search. The form states that the fee is $5 per name for each two-year period or portion of one; an indictment number, if provided, has a separate certificate fee.

Who needs it

Anyone requesting a search of criminal records maintained by the Chenango County Clerk’s Office can complete and submit this form.

How to submit it

Send the completed form to the Chenango County Clerk’s Office, 5 Court Street, Norwich, NY 13815. The form says checks are payable to Chenango County Clerk.

About notarization

This document is signed and dated without a notary; it mentions no notarized or sworn attachment, so the signer just signs and dates it.

How to submit this form

1
Download the Form
Download the Request for Criminal Record Search form.
2
Complete the Request
Provide your contact details, the person’s name and required date of birth, and the time period to be searched.
3
Gather Payment
Include the required fee; the form says checks are payable to Chenango County Clerk.
4
Send It to the Clerk
Send the completed form to the Chenango County Clerk’s Office, 5 Court Street, Norwich, NY 13815.

Frequently asked questions

What does the criminal record search request form ask for?: It asks for the requester’s contact information, the searched person’s name and required date of birth, the time period to search, and optional identifying details.
How much does a criminal record search cost?: The form states a fee of $5 for each name searched for every two-year period or portion thereof. If an indictment number is provided, it says the fee is $5 for a Certificate of Conviction, with no search fee.
How do I submit the criminal record search request?: Send the completed form to the Chenango County Clerk’s Office at 5 Court Street, Norwich, NY 13815. The form says checks are payable to Chenango County Clerk.
Do I need a notary for the criminal record search request?: No. This form is signed and dated without a notary, and it mentions no notarized or sworn attachment.

Need something notarized?

This Request for Criminal Record Search doesn’t need a notary, but if you have another Chenango County form that does, a commissioned online notary can help.