Minnesota Criminal Records Check Release Form
If the police department wants to notify the court overseeing your case that you have a clean criminal record in the State of Minnesota, the Minnesota Criminal Records Check Release Form has to be used.
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Criminal History Check Release Full Name List Any Other Names By Which You Have Been Known : First Middle Last _________________________________________________________________________________ _________________________________________________________________________________ Date of Birth † Female † Male Race I hereby give permission to law enforcement ag encies, the Bureau of Criminal Apprehension and/or the Federal Bureau of Investigation to release criminal history information to the court. Your Signature If incomplete, we will not be able to process your application. Record information will be placed in the name change file that is accessible to the public. NAM103 State ENG Rev 9/07 www.mncourts.gov/forms Page 1 of 1
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