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The SP 4 164 form is a crucial document utilized by individuals and organizations in Pennsylvania to request a criminal record check from the Pennsylvania State Police Central Repository. This form is completed in ink by the requester to ensure legibility, as unclear submissions will be returned unprocessed. The purpose of the request can vary, ranging from employment screenings to international adoptions and other legal matters. Interestingly, there are different fees associated with the requests: $10 for non-notarized checks and $15 for notarized checks. It's important that payment is made via certified check or money order, addressed to the Commonwealth of Pennsylvania, as cash or personal checks are not accepted. The requester must provide personal details, including the subject's name, date of birth, and social security number, to facilitate an accurate record comparison against the repository's data. Responses may take considerable time, often exceeding four weeks, thereby emphasizing the value of planning ahead for all parties involved. Additional guidelines specify that requests for personal records require a valid government-issued photo ID and are limited to the individual requesting the information or their legal representative. With these aspects in mind, understanding the SP 4 164 form becomes essential for anyone navigating the Pennsylvania criminal background check process.

Sp 4 164 Example

SP 4-164 (2-2013)PENNSYLVANIA STATE POLICE

REQUEST FOR CRIMINAL RECORD CHECK

This form is to be completed in ink by the requester – (information will be mailed to the requester only). If this form is not legible or not properly completed, it will be returned unprocessed to the requester. A response may take four weeks or longer.

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https://epatch.state.pa.us

NAME/

REQUESTER

ADDRESS

CITY/STATE/

ZIP CODE

CONTACT TELEPHONE NUMBER (INCLUDING AREA CODE)

 

 

 

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FOR CENTRAL REPOSITORY USE ONLY

CONTROL NUMBER

AFTER COMPLETION MAIL TO:

PENNSYLVANIA STATE POLICE CENTRAL REPOSITORY – 164 1800 ELMERTON AVENUE HARRISBURG, PA 17110-9758

1-888-QUERYPA (1-888-783-7972)

DO NOT SEND CASH OR PERSONAL

CHECK

CHECK ONE BLOCK

INDIVIDUAL/NONCRIMINAL JUSTICE AGENCY – ENCLOSE A CERTIFIED CHECK/MONEY ORDER IN THE AMOUNT OF $10.00, PAYABLE TO:

COMMONWEALTH OF PENNSYLVANIA

THE FEE IS NONREFUNDABLE

NOTARIZED INDIVIDUAL/NONCRIMINAL JUSTICE AGENCY – ENCLOSE A CERTIFIED CHECK/MONEY ORDER IN THE AMOUNT OF $15.00, PAYABLE TO:

COMMONWEALTH OF PENNSYLVANIA

THE FEE IS NONREFUNDABLE

FEE EXEMPT-NONCRIMINAL JUSTICE AGENCY – NO FEE

NAME/SUBJECT OF RECORD CHECK (FIRST)

(MIDDLE)

(LAST)

MAIDEN NAME AND/OR ALIASES

SOCIAL SECURITY NUMBER

DATE OF BIRTH (MM/DD/YYYY)

SEX

RACE

The Pennsylvania State Police response will be based on the comparison of the data provided by the requester

against the information contained in the files of the Pennsylvania State Police Central Repository only

FEES FOR REQUESTS - $10.00. NOTARIZED FEE REQUESTS - $15.00.

***MAKE ALL MONEY ORDERS PAYABLE TO: COMMONWEALTH OF PENNSYLVANIA ***

◄◄◄◄◄◄CHECK BOX THAT MOST APPLIES TO THE PURPOSE OF THIS REQUEST►►►►►►

REASON FOR REQUEST

INTERNATIONAL ADOPTION - INTERNATIONAL ADOPTION MUST BE NOTARIZED AND MAILED IN. ($15.00 FOR REQUEST)

ADOPTION (DOMESTIC)

ATTORNEY

BANKING

BAR ASSOCIATION

CHURCH

CHILD CARE

EDUCATION

ELDER CARE

EMERGENCY MANAGEMENT

EMPLOYMENT/SCREENING

FOSTER CARE

HEALTHCARE

HOUSING

INSURANCE LICENSE

MENTAL HEALTH

NURSE AID TRAINING

OTHER _________________

PASSPORT

PRIVATE INVESTIGATIONS

SOCIAL SERVICES

TENANT CHECK

VISA

VOLUNTEER AMBULANCE/FIREFIGHTER

VOLUNTEER

ACCESS & REVIEW - (NOT FOR EMPLOYMENT PURPOSES. MUST BE MAILED INTO THE CENTRAL REPOSITORY WITH A COPY OF A VALID GOVERNMENT ISSUED PHOTO ID, SEE TERMS & CONDITIONS)

AVAILABLE ONLY TO SUBJECT OF RECORD OR LEGAL REPRESENTATIVE WITH LEGAL AFFIDAVIT AND REQUIRED COPY OF GOVERNMENT

PHOTO ID ATTACHED FOR THE PURPOSE OF REVIEWING YOUR CRIMINAL HISTORY.

WARNING: 18 Pa.C.S. 4904(b) UNDER PENALTY OF LAW - MISIDENTIFICATION OR FALSE STATEMENTS OF IDENTITY TO OBTAIN CRIMINAL HISTORY INFORMATION OF ANOTHER IS PUNISHABLE AS AUTHORIZED BY LAW.

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Form Characteristics

Fact Name Description
Purpose of the Form The SP 4-164 form is used to request a criminal record check from the Pennsylvania State Police. It is important for verifying an individual's background for various purposes such as employment, adoption, and other legal requirements.
Processing Time Requests made using this form may take four weeks or longer to receive a response. If the form is not legible or is incorrectly filled out, it will be returned unprocessed.
Fees Associated A fee of $10.00 is required for non-notarized requests, and $15.00 for notarized requests, both payable to the Commonwealth of Pennsylvania. These fees are nonrefundable.
Legal Warning According to 18 Pa.C.S. 4904(b), it is illegal to provide false statements of identity to obtain someone else's criminal history information. Violators may face legal consequences.

Guidelines on Utilizing Sp 4 164

Completing the SP 4-164 form is a necessary process for those seeking a criminal record check in Pennsylvania. The information provided will be reviewed and processed by the Pennsylvania State Police Central Repository. It's important to complete the form carefully and correctly to avoid any delays in receiving a response.

  1. Begin by using a blue or black pen to fill out the form. Ensure all information is legible. Incomplete or illegible forms will be returned.
  2. In the section labeled NAME/REQUESTER, write your full name.
  3. Fill in your ADDRESS, including the street address, city, state, and ZIP code.
  4. Provide your CONTACT TELEPHONE NUMBER, including the area code. Ensure this number is current and accurate for any follow-up communication.
  5. Check the box that corresponds to your request type: INDIVIDUAL/NONCRIMINAL JUSTICE AGENCY or NOTARIZED INDIVIDUAL/NONCRIMINAL JUSTICE AGENCY.
  6. If applicable, enclose the required payment: $10.00 for non-notarized requests or $15.00 for notarized requests. Payments must be made via certified check or money order, and made payable to “COMMONWEALTH OF PENNSYLVANIA.”
  7. In the NAME/SUBJECT OF RECORD CHECK section, provide the requested first name, middle name, last name, and maiden name or aliases.
  8. Enter your SOCIAL SECURITY NUMBER and DATE OF BIRTH in the specified format (MM/DD/YYYY).
  9. Indicate your SEX and RACE.
  10. Mark the REASON FOR REQUEST that best describes your situation. Choose from the options provided or write in another reason if necessary.
  11. If applicable, complete any sections relevant to your request, such as the one for international adoption.
  12. Before submitting, review the entire form to ensure all fields are completed accurately and clearly.
  13. Once satisfied with your entries, mail the completed form to the Pennsylvania State Police Central Repository at:
    1800 Elmerton Avenue
    Harrisburg, PA 17110-9758

After submitting the form, a response may take four weeks or longer. It is advisable to keep a copy of the completed form and your payment method for your records. If a quicker response is desired, consider utilizing the online resources available on the Pennsylvania State Police website.

What You Should Know About This Form

What is the purpose of the SP 4-164 form?

The SP 4-164 form is used to request a criminal record check from the Pennsylvania State Police. This form is essential for individuals who may need to verify their criminal history for various reasons, including volunteering, employment screening, adoption, or legal purposes. By completing this form, you can ensure that the information you provide is checked against the state’s central repository of criminal records.

How should I ensure that my SP 4-164 form is completed correctly?

To avoid any delays, fill out the SP 4-164 form clearly and completely using ink. Make sure all required fields are filled in, including your contact information, the name and details of the individual being checked, and the reason for the request. Incomplete or illegible forms will be returned unprocessed, which could significantly extend the time it takes to receive your results.

What are the fees associated with the SP 4-164 form?

There are specific fees based on the type of request you are making. For individuals or non-criminal justice agencies, the fee is $10. If you need a notarized request, the fee increases to $15. It's important to remember that these fees are nonrefundable, whether or not you receive a response from the Pennsylvania State Police.

How long will it take to receive my criminal record check?

After submitting your SP 4-164 form, be prepared for a wait. The response time may take four weeks or longer. For a quicker response, consider checking the Pennsylvania State Police’s website, where there may be faster processing options available.

What should be included with my request?

Along with your completed SP 4-164 form, include the applicable fee in the form of a certified check or money order made payable to "Commonwealth of Pennsylvania." If your request is for access and review of your own criminal history, include a copy of a valid government-issued photo ID. This ensures that your request is processed with the appropriate level of verification.

Common mistakes

Completing the SP 4-164 form requires careful attention to detail, yet many individuals make critical mistakes that can delay their request for a criminal record check. One common error is failing to include complete and accurate contact information. Without a valid address and phone number, the Pennsylvania State Police may struggle to reach you with the results. This oversight could result in extended processing times, or worse, the form may be returned unprocessed.

Another frequent mistake occurs when individuals do not properly check the relevant block for the purpose of their request. Each purpose category has specific requirements, especially for notarized requests and fee exemptions. If the chosen block doesn’t match the purpose or you neglect to include necessary enclosures, your application may be deemed incomplete. It is essential to review the options carefully to ensure compliance with the requirements.

Many requesters also fail to provide legible handwriting. The instructions explicitly state that the form must be completed in ink and be legible. If the information is difficult to read, it will lead to unnecessary delays as the agency may need to clarify or, in the worst case, return your application without processing it. This is a simple yet critical aspect that one should not overlook.

Lastly, incorrectly submitting payment is another error people frequently make. Whether it’s sending cash or personal checks—both of which are prohibited—or failing to attach the correct amount, these mistakes can halt the processing of your request. Ensure that any payment is in the form of a certified check or money order made out to the "Commonwealth of Pennsylvania" as specified. The fees are nonrefundable, and any misstep in this area could push back your timeline significantly.

Documents used along the form

The SP 4 164 form is often accompanied by various other documents to ensure proper processing of requests for criminal record checks in Pennsylvania. Below are some commonly used forms and documents that support or are necessary for completing the application process.

  • SP 4-164A: This is the notarized version of the SP 4 164 form. It is required for specific requests where notarization is needed, such as international adoptions. The notarized form must be submitted with a fee of $15, payable to the Commonwealth of Pennsylvania.
  • Government Issued Photo ID: This document is needed when requesting access and review of criminal history information. It must accompany the SP 4 164 form along with a legal affidavit if the requester is not the individual subject of the record.
  • Payment Method Documentation: Requesters must include a certified check or money order as payment. The payment method should be clearly documented and made out to the Commonwealth of Pennsylvania, detailing the fee for the request.
  • Legal Affidavit: This document is required if the requester is a legal representative of the subject of the record. It serves to verify the authority of the requester to obtain criminal history information on behalf of the individual.
  • Request for Waiver of Fees: In cases where the request falls under a fee-exempt category, this form may be needed to justify the exemption. Proper documentation must support the request for a waiver.
  • Cover Letter: This is an optional document where the requester can explain the purpose of the request or any specific instructions for the processing of their application. Including a cover letter may help provide clarity and expedite the process.

Each of these documents has a specific role in facilitating a smooth request process when submitting the SP 4 164 form. Ensuring that all necessary forms and supporting documents are included can significantly reduce processing delays.

Similar forms

  • Form Request for Background Check: Similar to the SP 4 164, this document allows individuals or organizations to request background checks on persons for various purposes. Both forms require personal information and define specific reasons for the inquiry.
  • Employment Background Check Release: This form enables employers to obtain an applicant’s criminal history. Like the SP 4 164, it mandates the inclusion of personal details and consent from the individual being checked.
  • Fingerprint Submission Form: Used to submit fingerprints for a background check, this form also necessitates essential personal data. Both documents serve to facilitate the screening process while complying with state requirements.
  • Child Protective Services Clearance: This form is required for those seeking to work with children. Similar to the SP 4 164, it necessitates personal information and addresses specific eligibility criteria based on the applicant’s history.

Dos and Don'ts

When filling out the SP 4-164 form, following best practices can help ensure a smooth process. Here are five important dos and don’ts to keep in mind:

  • Do use ink to fill out the form. A legible submission is crucial!
  • Do double-check all provided information for accuracy. Mistakes can lead to delays.
  • Do include the correct payment type with your form. Either a certified check or money order is acceptable.
  • Do ensure your application is mailed to the Pennsylvania State Police Central Repository address listed on the form.
  • Do remember that responses may take four weeks or more, so plan accordingly.
  • Don’t send cash or personal checks. Only certified checks or money orders are allowed.
  • Don’t omit your contact information. Providing this ensures the repository can reach you if necessary.
  • Don’t forget to include a valid government-issued photo ID if you’re requesting a review of your criminal history.
  • Don’t leave any sections blank. Incomplete forms are likely to be returned unprocessed.
  • Don’t assume that your request will be processed immediately. It's essential to allow sufficient time.

Misconceptions

Understanding the SP 4-164 form is crucial for navigating the process of requesting a criminal record check in Pennsylvania. However, various misconceptions can lead to confusion. Here are six common misunderstandings about this form:

  • Misconception 1: The form can be completed in any writing style.
  • The SP 4-164 form specifically requires completion in ink. If the form is not legible, it will be returned unprocessed to the requester.

  • Misconception 2: The response time is always quick.
  • A response may take four weeks or longer. Many requesters expect immediate results, but it is essential to plan accordingly and not to rely on prompt processing.

  • Misconception 3: Personal checks are an acceptable form of payment.
  • The guidelines explicitly state that personal checks should not be sent. Only certified checks or money orders made payable to the 'Commonwealth of Pennsylvania' are accepted.

  • Misconception 4: There are no fees for individual requests.
  • Fees do apply; a standard request costs $10.00, while notarized requests require a $15.00 fee. The fees are non-refundable, which means that understanding the cost is important before submission.

  • Misconception 5: Anyone can request another person’s criminal history.
  • Access to a criminal history is restricted. Only the subject of the record or their legal representative can obtain this information, and it requires proper identification and possibly additional documentation.

  • Misconception 6: This form is only for employment purposes.
  • The SP 4-164 can be used for various reasons beyond employment, including adoptions, volunteer positions, and background checks for specific agencies. The requester should indicate the purpose clearly on the form.

Key takeaways

When it comes to filling out and using the SP 4 164 form, a few crucial points can help ensure a smooth process. Here are ten key takeaways:

  • Complete in Ink: Make sure to fill out the form with black or blue ink. A legible submission is vital, as illegible forms will be returned.
  • Direct Mailing Required: The completed form must be mailed to the Pennsylvania State Police Central Repository at the address provided.
  • Processing Time: Be prepared to wait; responses can take four weeks or longer, so plan accordingly.
  • Online Option: Consider visiting the Pennsylvania State Police website for a potentially quicker response.
  • Fee Payment: Correct payment is essential. Standard requests require a $10 fee, while notarized requests cost $15. This payment must be made via a certified check or money order.
  • Do Not Send Cash: Never send cash or personal checks with your form; only certified checks or money orders are accepted.
  • Correct Box Selection: Be sure to check the appropriate box that reflects your reason for the request, as this can affect processing.
  • Provide Accurate Information: Fill in complete and accurate details for the subject of the record, including names, social security number, date of birth, and demographic information.
  • Legal Requirements: If you are requesting a review of your own criminal history, include a valid government-issued photo ID and be aware of the legal stipulations regarding misidentification.
  • Use of Services: This form is utilized for various purposes including employment screening, and requirements may vary based on the reason selected.

By keeping these points in mind, you'll increase the likelihood of a smooth and successful experience when using the SP 4 164 form.