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Criminal History

For individuals with criminal convictions only.

Submit to the Department

  1. Criminal History Supplemental Form (PSS_CHS); you can put up to three (3) criminal convictions on one (1) form.

    For each conviction, you must supply:

    1. A statement containing; offense convicted of, date of conviction, location and circumstances of conviction.
    2. A certified copy of all applicable criminal conviction(s), police and court records.
    3. A statement on the current status of parole or probation.
    4. Supporting documentation - reference letters, pardons, rehabilitation, restitution of rights.

Important Information

  1. Misrepresentation, falsification or omission of pertinent information may be cause for denial and may result in criminal charges.

Forms