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The SP167 form, officially known as the Criminal History Record Name Search Request, serves an essential purpose for individuals and organizations seeking to obtain criminal history records. This form is crucial in various contexts, including domestic and international adoption cases, applications for visas, and other specific needs that require a review of an individual's criminal background. Users complete the form by providing detailed information such as names, race, sex, date of birth, and, optionally, a Social Security number to facilitate a thorough search. Importantly, the request includes an affidavit section, where consent must be given to authorize the Virginia State Police to conduct the search and release the results to the designated agent. The form also outlines fees for service, which vary depending on whether the request is made on a volunteer basis for a non-profit organization or for personal inquiries. Clear payment instructions ensure that the request is processed efficiently, allowing agencies and individuals to have access to critical information that impacts decision-making processes. Understanding how to fill out the SP167 form correctly is vital for a successful request and for complying with all necessary legal requirements.

Sp 167 Example

SP-167 (Revised 12-01-2012)

CRIMINAL HISTORY RECORD NAME SEARCH REQUEST

PURPOSE OF THIS REQUEST (Check only one):

DOMESTIC ADOPTION

INTERNATIONAL ADOPTION

COUNTRY

 

 

VISA (INTERNATIONAL TRAVEL)

 

OTHER (please specify)

 

 

 

 

 

 

 

 

 

 

NAME INFORMATION TO BE SEARCHED:

 

 

 

 

 

LAST NAME

 

FIRST NAME

MIDDLE NAME

MAIDEN NAME

RACE

SEX DATE OF BIRTH

/

/

(MM/DD/YYYY)

SOCIAL SECURITY NUMBER

AFFIDAVIT FOR RELEASE OF INFORMATION:

I hereby give consent and authorize the Virginia State Police to search the files of the Central Criminal Records Exchange for a criminal history record and report the results of such search to the agent or individual authorized in this document to receive same.

State of

County

Signature

City of

 

; to wit: Subscribed and sworn to before me on:

(MM/DD/YYYY)

My commission expires:

 

My registration # is:

Signature of Notary Public

SIGNATURE OF PERSON MAKING REQUEST:

As provided in Section 19.2-389, Code of Virginia, I hereby request the criminal history record of the individual named above and swear or affirm I have the consent of the individual to obtain their record and will not further disseminate the information received, except as provided by law.

State of

County

Signature of Individual Making Request

City of

 

; to wit: Subscribed and sworn to before me on:

(MM/DD/YYYY)

My commission expires:

 

My registration # is:

Signature of Notary Public

NAME AND MAILING ADDRESS OF AGENCY, INDIVIDUAL OR AUTHORIZED AGENT MAKING REQUEST:

Mail Reply To:

NAME

ATTENTION

 

 

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

CITY

STATE

ZIP CODE

 

 

 

 

 

 

 

FEES FOR SERVICE:

 

 

 

 

 

 

 

* FEES For Volunteers with Non-Profit Organizations:

$15.00 CRIMINAL HISTORY SEARCH

 

 

 

$8.00 CRIMINAL HISTORY SEARCH

$20.00 COMBINATION CRIMINAL HISTORY & SEX OFFENDER SEARCH

 

 

$16.00 COMBINATION CRIMINAL HISTORY & SEX OFFENDER SEARCH

 

 

 

 

*To be entitled to reduced price, services must be on volunteer basis for a non-profit organization with a tax exempt number. Attach documentation to form which supports volunteer status and include organization’s name, address, and the tax exempt identification number.

METHOD OF PAYMENT: (Note: Personal Checks Not Accepted)

Business or Certified check or Money order (payable to Virginia State Police)

CHARGE CARD:

MasterCard

 

OR

Visa

 

Account Number:

 

-

-

-

 

Expiration:

/

Signature of Cardholder:

 

 

 

 

 

 

 

Virginia State Police Charge Account Number:

 

 

 

Mail Request To:

Virginia State Police

Central Criminal Records Exchange – NF

P. O. Box 85076

Richmond, Virginia 23261-5076

ATTN: NEW FORM

FOR STATE POLICE USE ONLY – DO NOT WRITE BELOW THIS LINE

Response based on comparison of name information submitted in request against a master name index maintained in the Central Criminal Records Exchange only.

No Conviction Data – Does Not Preclude the Existence of an Arrest Record

No Criminal Record – Name Search Only

No Criminal Record – Fingerprint Search

No Sex Offender Registration Record

Criminal Record Attached

Purpose code:

C

N

O

Date:

 

By CCRE/

SP-167 (Revised 12-01-2012)

CRIMINAL HISTORY RECORD NAME SEARCH REQUEST

INSTRUCTIONS FOR COMPLETING THE CRIMINAL HISTORY REQUEST FORM

Pay By: Certified Check/Money Order or Business check made payable to “Virginia State Police”

OR we accept VISA and MasterCard

Personal Checks Not Accepted

Effective November 1, 2010, the public is hereby placed upon notice that

returned checks or dishonored money orders and/or credit card payment denials will incur a handling fee of $50 in addition to the amount of the original payment.

Requesting goods or services will be deemed to be acceptance of these terms.

Code of Virginia §2.2-4805.

Discard these Instructions Prior to Submitting to State Police

Refer to Page 2 of these Form Instructions for Pricing Structure and Types of Name Searches Available

If you are interested in obtaining a name search of the “Sex Offender and Crimes

Against Minors Registry,” refer to the instructions on page 2 of this form.

The Form Must be TYPED OR NEATLY HAND-PRINTED.

Complete the Criminal History Record Request by following these instructions:

***

PURPOSE OF THIS REQUEST:

Primary reason for request.

NAME INFORMATION TO BE SEARCHED:

Name, race, sex, date of birth, and social security number on whom the criminal record name

 

search is to be conducted. Providing the social security number is voluntary; however, it is a

 

screening tool that is used for this request to be processed in a more timely manner. Failure

 

to provide this number may result in an inability to process this request due to multiple

 

records with similar names and demographics. Without this additional identifier, the form

 

may be returned to the requestor unprocessed, and the applicant will be required to submit a

 

set of fingerprints along with this request form to determine if this applicant has a criminal

 

record. Social Security Numbers provided will be used to help identify the proper record and

 

will be used for no other purpose.

AFFIDAVIT FOR RELEASE OF

Individual’s signature on which the search is to be conducted. The signature indicating

INFORMATION:

consent must be notarized for the search to be conducted and mailed to the individual or

 

authorized agent (if applicable).

SIGNATURE OF PERSON MAKING REQUEST:

Affidavit must be signed by authorized agent and notarized to receive the search results.

NAME AND MAILING ADDRESS OF AGENCY,

Name and complete mailing address of the individual, agency or authorized agent to receive

INDIVIDUAL OR AGENT MAKING REQUEST:

processed criminal record search must be completed.

FEES FOR SERVICE:

Indicate fee that is submitted, based upon type of request. Fees for volunteer of non-profit

 

organizations must be accompanied with their tax exempt number.

METHOD OF PAYMENT:

Indicate method of payment

Mail the Completed SP-167 “Criminal History Record Request” to:

Virginia State Police

Central Criminal Records Exchange – NF

P.O. Box 85076

Richmond, Virginia 23261-5076

Page 2

SP-167 (Revised 12-01-2012)

Instructions For Requesting a Search of the “Sex Offender and Crimes Against Minors Registry”

In accordance with Section 9.1-9009.1-918, Code of Virginia, the Central Criminal Records Exchange of the Virginia Department of State Police is responsible for maintaining the above captioned Registry containing name, personal descriptive/conviction information and photographs of individuals convicted of specific sex offenses. The law also provides for the dissemination of sex offender registrations for the following purpose: Child/adult care, child minding, public/child protection, daycare services, volunteering services or employment. To request an inquiry of the Registry, SP-266 “Sex Offender and Crimes Against Minors Registry” name search forms may be obtained by downloading from the Virginia State Police website: http://www.vsp.virginia.gov.

There are two classifications of sex offenders: the sex offender and violent sex offender. A single name search can be conducted to determine if a person is convicted of a violent or sex offense by completing and SP-266 form. Violent sex offenders can be searched on the Virginia State Police website: Virginia State Police Sex Offender and Crimes Against Minors Registry http://sex-offender.vsp.virginia.gov/sor/.

Cost Structure and Types of Records Searches Available

***

CRIMINAL HISTORY RECORD

$15.00 per search of Criminal History Name File.

COMBINATION CRIMINAL HISTORY/SEX

$20.00 for a COMBINATION criminal history record name search conducted and a

OFFENDER REGISTRY

Sex Offender and Crimes Against Minors name search.

COMPLETE SEX OFFENDER REGISTRY

$15.00 per search of the Sex Offender Registry only through the submission of an

 

SP-266 “Sex Offender and Crimes Against Minors” name search request form.

VIOLENT SEX OFFENDERS

No Charge for searches conducted of violent offender registrations ONLY through

 

the Virginia State Police website: Virginia State Police Sex Offender and Crimes

 

Against Minors Registry http://sex-offender.vsp.virginia.gov/sor/.

NON-PROFIT ORGANIZATION COMBINATION CRIMINAL HISTORY/SEX OFFENDER REGISTRY

$16.00 for a COMBINATION criminal history record name search conducted for a “Criminal History Record Name Search” and “Sex Offender and Crimes Against Minors.” The purpose of this search is for volunteering services for a non-profit organization. The SP-167 must be submitted attached to documentation explaining the purpose of the search is for volunteering services for a non-profit organization. The documentation must include the name of the organization, address and the tax- exempt identification number of the organization.

NON-PROFIT ORGANIZATION COMPLETE

$8.00 for each name search of the Sex Offender Registry conducted for individuals

SEX OFFENDER

volunteering for a non-profit organization. The SP-167 must be submitted attached to

 

documentation explaining the purpose of the search is for volunteering services for a

 

non-profit organization. The documentation must include the name of the

 

organization, address and the tax-exempt identification number of the organization.

Page 3

Form Characteristics

Fact Name Details
Form Title SP-167: Criminal History Record Name Search Request
Governing Law Section 19.2-389, Code of Virginia, governs the use of this form.
Authorized Purposes The form can be used for domestic adoption, international adoption, country visa applications, or other specified reasons.
Information Required Required details include names, date of birth, race, sex, and optional social security number of the individual being searched.
Consent Requirement The applicant must provide a notarized consent to allow for a criminal history search.
Fees for Service Standard fees vary from $8.00 to $20.00, with reduced fees available for non-profit volunteer organizations.
Payment Methods Accepted payment methods include certified checks, money orders, and credit cards. Personal checks are not accepted.
Submission Address Completed forms should be mailed to the Virginia State Police Central Criminal Records Exchange in Richmond, Virginia.
Record Search Limitations A name search may not reveal all criminal history, and a fingerprint search might be required if the name search yields multiple matches.
Record Access for Non-Profits Non-profits seeking volunteer-related searches must include documentation of their tax-exempt status with the application.

Guidelines on Utilizing Sp 167

Next, you'll fill out the SP-167 form for a criminal history record name search. Follow these steps carefully to ensure that your request is processed smoothly.

  1. Purpose of Request: At the top of the form, check only one box to indicate the main reason for your request. Options include domestic adoption, international adoption, country visa, and other.
  2. Name Information to be Searched: Fill in the individual's last name, first name, middle name, and maiden name. Also, specify their race, sex, date of birth (MM/DD/YYYY), and optional social security number.
  3. Affidavit for Release of Information: The individual on whom the search is being conducted must sign this section. The signature must be notarized, confirming their consent for the search.
  4. Signature of Person Making Request: If you are not the individual being searched, you must sign here, indicating that you have consent. This signature also needs to be notarized.
  5. Name and Mailing Address of Agency or Individual: Provide the complete name and mailing address where the results should be sent. This is to ensure accurate delivery.
  6. Fees for Service: Indicate the fee based on the type of search you are requesting. Refer to the fee structure on the form for guidance.
  7. Method of Payment: Specify your payment method. Acceptable payments include a certified check, money order, or business check made payable to “Virginia State Police.” Alternatively, you can use a MasterCard or Visa. Personal checks are not accepted.
  8. Mail the Completed Form: Once you have completed the form, mail it to the Virginia State Police at the address provided.

Taking these steps will help ensure your request is complete and accurately recorded. Be sure to double-check all entered information to avoid any delays in processing.

What You Should Know About This Form

What is the purpose of the SP 167 form?

The SP 167 form is used to request a criminal history record name search from the Virginia State Police. The primary purposes for requesting this search include domestic or international adoption, securing a country visa for international travel, or other specified reasons. It is important to check only one box to clearly define the purpose of the request.

What information is needed to complete the SP 167 form?

To complete the form, you need to provide personal details of the individual whose history is being searched. This includes the last name, first name, middle name, maiden name, race, sex, date of birth, and social security number. The social security number is optional but can expedite the processing of the request. Failing to include it may delay your request or require additional steps, like submitting fingerprints.

How do I authorize a search of someone else's criminal history?

You must provide a signed affidavit for the release of information on the form. This signature must be notarized, indicating that you have the individual's consent to conduct the search and that you will not disclose the results further, except where permitted by law.

What are the fees associated with the SP 167 form?

Fees vary depending on the type of search requested. For instance, a criminal history search costs $15 for volunteers with non-profit organizations, while it is $20 for a combination search. Be sure to attach documentation supporting your volunteer status if you seek reduced pricing related to non-profit work. Personal checks are not accepted; only certified checks, business checks, money orders, or credit cards can be used for payment.

Where do I send the completed SP 167 form?

Mail the completed form to the Virginia State Police at the Central Criminal Records Exchange. The address is P.O. Box 85076, Richmond, Virginia 23261-5076. Ensure you send it through regular mail or an appropriate courier service, allowing for sufficient processing time.

What happens if my request is processed without including a social security number?

If the social security number is not provided, the request may take longer to process or could be returned to you unprocessed if there are multiple records with similar names and details. In such cases, you may be required to submit fingerprints along with the request to verify the individual's criminal history.

Can I check the status of my request after I submit it?

The form does not provide a mechanism for immediate status updates. However, you may contact the Virginia State Police directly for inquiries about your request. It is advisable to allow several weeks for processing, considering applicable workload and backlog at the Central Criminal Records Exchange.

Common mistakes

Filling out the SP 167 form can be straightforward, but many people make errors that can lead to delays or complications. One common mistake is not checking the appropriate purpose box. Each box—such as domestic adoption, international adoption, or other—has a specific implication for the request. Failing to select the correct purpose may result in the authorities returning the form for correction, thereby extending the processing time.

Another issue often arises with the name information section. It is essential to provide all requested details accurately, including the last name, first name, middle name, and maiden name if applicable. A frequent error is leaving out the middle name or misspelling any part of the name. Such omissions can lead to confusion, especially when multiple individuals may have similar names, complicating the records search.

Many applicants overlook the social security number section. While this is voluntary, not including the social security number can slow down the processing of the request. The absence of this critical identifier might lead to the inability to process the request due to similar names sharing the same demographic information. Thus, it is advisable to include this number if available.

Notary signatures present another frequent issue. Many individuals fail to ensure that the affidavit for the release of information is properly notarized. The signature affirming consent must be legally verified before the form is accepted. Without this, the request cannot proceed, which can lead to significant delays in obtaining the criminal history record.

Lastly, applicants often misunderstand the fees involved. Submitting the wrong payment method or incorrect fee can cause additional issues. Personal checks are not accepted, and applicants must ensure they are using certified checks, money orders, or credit cards. Failing to provide the correct amount may result in the request being returned or processed incorrectly, introducing further delays in receiving the necessary information.

Documents used along the form

The SP-167 form, or the Criminal History Record Name Search Request, is commonly used for various purposes such as domestic and international adoption, or visa applications. Alongside this form, several other documents often play a crucial role in the criminal background check process. Understanding these associated documents can facilitate a smoother and more efficient request process.

  • SP-266 Form: This is the request form for searching the Sex Offender and Crimes Against Minors Registry. It is used to determine if an individual is registered as a sex offender, which can be crucial for child care and protection services.
  • Affidavit of Consent: This document may accompany the SP-167 form, proving that the individual whose background is being checked has provided consent for the request. It must include a notarized signature to be valid.
  • Fingerprint Card: In some cases, especially when the social security number is not provided, a fingerprint card may be required. This helps ensure a more accurate background check by matching the fingerprints to the individual’s criminal history.
  • Document of Non-Profit Status: For volunteers seeking reduced fees, proof of tax-exempt status must accompany the request. This documentation should specify that the volunteer work is being carried out under a registered non-profit organization.
  • Payment Authorization Form: This form indicates how payment will be made for the background check services. It is essential for facilitating the processing of the request, ensuring that the processing fee is authorized.
  • Criminal Record Release Statement: This document may be used to further clarify the intent and scope of the background check. It details what specific information can be released and to whom.
  • Requesting Agency Letter: If an agency is making the request on behalf of an individual, a letter may be necessary. This letter should explain the reason for the request and affirm that the agency has the individual's consent.
  • Notary Acknowledgment: Both the signature of the individual making the request and the person's consent must be notarized. A notary acknowledgment may need to be included to ensure legal validity of the request.

Each of these accompanying documents serves a vital function in the overall process of conducting a criminal history check. Being well-prepared and understanding the requirements can help streamline requests and ensure compliance with the necessary legal procedures.

Similar forms

  • SP-266: Sex Offender and Crimes Against Minors Registry Request Form - This form is used to request a name search specifically for individuals listed in the Sex Offender and Crimes Against Minors Registry. Like SP-167, it requires detailed personal information but focuses solely on offenders.
  • Fingerprint Submission Form - This document is utilized when a more comprehensive background check is required, often necessitating fingerprints. Similar to SP-167, it collects identifying information and serves a vital purpose in verifying an individual's criminal history.
  • Background Check Authorization Form - This form allows individuals to authorize third parties, such as employers or agencies, to conduct a background check. Both forms require consent and authenticate the individual's agreement to the search process.
  • Adoption Background Check Form - Used in adoption procedures, this form gathers similar information about prospective parents as the SP-167 does for name searches. The goal remains to ensure a safe environment for children by screening applicants' histories.
  • Request for Criminal History Records Form - This document seeks broader criminal history information from law enforcement agencies. Like the SP-167, it necessitates consent from the individual being searched and often includes specific details such as the person's name and date of birth.
  • Volunteer Background Check Form - Tailored for organizations seeking to vet volunteers, this form echoes the SP-167's intent and structure. It requests personal identifiers and requires consent, emphasizing the importance of safe volunteer engagements.

Dos and Don'ts

When filling out the SP-167 form, it's essential to navigate the process correctly to ensure timely processing of your request. Here's a list of do’s and don’ts to keep in mind:

  • Do clearly indicate the purpose of your request by checking only one box.
  • Do provide all required name information including last name, first name, and date of birth.
  • Do ensure your signature on the affidavit is notarized, as this is necessary for processing.
  • Do include a complete mailing address for the agency or individual authorized to receive the results.
  • Do verify the payment method is acceptable; personal checks are not accepted.
  • Don't leave any required fields blank; incomplete forms can lead to delays.
  • Don't use a personal check; only certified checks, money orders, or credit cards are acceptable.
  • Don't forget to attach any required documentation for non-profit organization requests.
  • Don't forget to discard the instruction pages before mailing the form to Virginia State Police.
  • Don't assume providing a Social Security number is mandatory; it is voluntary but can expedite processing.

By adhering to these guidelines, you can help ensure a smooth and efficient processing of your SP-167 form request.

Misconceptions

  • Misconception 1: The SP 167 form is only for adoptions.
  • While it is often used for domestic and international adoption purposes, the SP 167 form can also be used for other requests, such as securing a visa or for other specified purposes.

  • Misconception 2: I must provide my Social Security number to use the form.
  • Providing your Social Security number is voluntary. However, including it can help process the request more quickly by reducing the chances of confusion with similarly named individuals.

  • Misconception 3: The form does not require notarization.
  • Both the affidavit for the release of information and the signature of the person making the request must be notarized. This helps ensure the authenticity of the information provided.

  • Misconception 4: I can pay with a personal check.
  • Personal checks are not accepted when submitting the SP 167 form. You must use a certified check, money order, or a credit card.

  • Misconception 5: Once submitted, my request is guaranteed to be processed quickly.
  • While every effort is made to process requests in a timely manner, delays can occur, especially if the information provided is insufficient or unclear.

  • Misconception 6: A "No Criminal Record" response means there are no arrests or offenses.
  • A "No Criminal Record" result only indicates that there are no convictions found. There may still be an arrest record that does not lead to a conviction.

  • Misconception 7: I can submit the form without proper documentation if I am a volunteer.
  • If you are volunteering for a non-profit organization and wish to receive reduced fees, you must attach documentation proving your volunteer status, including the organization's tax-exempt identification number.

  • Misconception 8: It is the same as a fingerprint-based background check.
  • The SP 167 form conducts a name-based search, which is not the same as a fingerprint-based background check. A fingerprint search may be required if the name search cannot clearly identify the individual.

  • Misconception 9: The SP 167 form is only relevant for local requests.
  • This form can be used for both local and out-of-state individuals, as it is designed to gather information from the Virginia State Police Central Criminal Records Exchange.

  • Misconception 10: There is no option for urgent requests.
  • While the processing time can vary, if you have an urgent need for the information, it’s best to follow up directly with the agency after submitting your request to inquire about your status.

Key takeaways

When filling out the SP-167 form, there are several important points to keep in mind to ensure your application is processed smoothly.

  • Understand the Purpose: Clearly identify the reason for your request. The options include domestic adoption, international adoption, visa requirements, and other purposes.
  • Provide Accurate Information: Complete the name information section accurately. This includes the individual's last name, first name, middle name, race, sex, date of birth, and social security number. Including the social security number can help speed up the process.
  • Notarization is Essential: The consent you provide must be notarized. This means a notary public must witness your signature. This step cannot be skipped; otherwise, the request may be invalid.
  • Payment Methods: Payments should be made by certified check, money order, or business check only. Personal checks are not accepted, and credit card payments must be provided with the correct account details.
  • Fees are Applicable: Be aware of the fees associated with the service. The cost may vary based on the type of search required, whether for volunteers, criminal history, or combinations of searches.
  • Mailing Instructions: Make sure to send the completed form to the correct address: Virginia State Police Central Criminal Records Exchange, P.O. Box 85076, Richmond, Virginia 23261-5076. Ensuring the proper delivery address is crucial for timely processing.
  • Keep Copies: Always retain a copy of your completed form and any supporting documentation for your records. This can help in following up on your request if necessary.
  • Deadlines Matter: Be mindful of any deadlines associated with your request, especially if your search is tied to time-sensitive matters like adoption or travel.

By keeping these points in mind, you can help ensure that your request is processed efficiently and effectively. Take the time to complete the form carefully, and reach out for assistance if you have any questions during the process.