Form Apd-29 - Applicant Record Check
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1APD-29
APPLICANT RECORDS CHECK
PD 407-161 (Rev. 01-09)
page ___ of ___
EXAM NO.
LIST NO.
DATE
COMPUTER INQUIRY:
SUFFOLK
AUXILIARY POLICE SECTION
INTERPOL
NYC PISTOL LICENSE
NLETS
NASSAU
FAMILY/ASSOCIATE CHECK
LEXISNEXIS
CREDIT REPORT
___________________
Request that a record check be conducted for the following named Applicant for possible appointment to this Department:
Last Name
First
M.I.
Occupation
Male
Female
Alias/Maiden Name
Social Security No.
Height
Ft.
In.
Weight
Race
Date of Birth
Place of Birth
PRESENT AND FORMER RESIDENCES:
UNTIL
STREET ADDRESS
CITY
STATE
ZIP
PRESENT
ALSO REQUEST RECORD OF THE FOLLOWING NAMED RELATIVES AND/OR ASSOCIATES:
M/F
LAST NAME
FIRST NAME
ADDRESS
RACE/D.O.B.
RELATIONSHIP
INVESTIGATOR __________________________________________________________ SQUAD NO. _____________
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