Fillable Printable Police Record Check Form - Ottawa
Fillable Printable Police Record Check Form - Ottawa
Police Record Check Form - Ottawa
Agency and Position Applying for:
NON-VOLUNTEER VOLUNTEER
Verified by:
Non/Profit Member:
Sex: M F
Maiden Name: Other Names Used: Date of Birth (yy/mm/dd): | |
Place of Birth: Home Phone Number: Business Phone Number:
FIVE YEAR ADDRESS HISTORY IF DIFFEREnT THAn AbOVE (*Any address outside Ottawa jurisdiction must include name of Police Service)
Unit/Number: Street: City: Prov.: Postal Code: How Long?:
Unit/Number: Street: City: Prov.: Postal Code: How Long?:
Unit/Number: Street: City: Prov.: Postal Code: How Long?:
Other Police Agency
1. I consent to a search being made in the automated criminal records retrieval system maintained by the Royal Canadian Mounted Police to find out if I have been charged
and/or convicted of any criminal offences or convicted and granted a pardon for any of the sexual offences that are listed in the schedule of the Criminal Records Act.
I understand that, as a result of giving this consent, if I am suspected of being the person named in a criminal record for one of the sexual offences listed in the schedule
to the Criminal Records Act in respect of which a pardon was granted or issued, that record may be provided by the Commissioner of the Royal Canadian Mounted Police
to the Solicitor General of Canada, who may then disclose all or part of the information contained in that record to a police service or other authorized body. That police
service or authorized body will then disclose that information to me.
2. I hereby release and discharge the Ottawa Police Service and all their agents from any and all claims, actions and demands for damages, loss or injury of any nature
arising from disclosure of information. I hereby authorize the Ottawa Police Service to inquire into and conduct local police information searches Canada wide and disclose
to myself details of police investigated incidents that the Ottawa Police believes may assist an agency in making an informed decision concerning my application.
Furthermore, I understand that upon the disclosure of information, the Ottawa Police Service and all their agents waive any responsibility for its use and or subsequent
dissemination by myself.
3. I certify that the information provided by me in this application is true and correct to the best of my knowledge and belief. I have read this consent, understand it and
agree to it in its entirety.
SIGNATURE OF APPLICANT: Signed this date: , 201
POLICE RECORDS CHECK FOR SERVICE
WITH THE VULnERAbLE SECTOR
< First Name, Middle Name, Surname
< Unit/Number, Street
< City, Province
< Postal Code
< How long have you lived at
this address?
This is to confirm that no criminal convictions, outstanding charges,
nor pardoned sex offenses have been found in the Canadian national
Repository of Criminal Records as a result of a search based on the
above name and date of birth. The search has not been confirmed
by fingerprints.
This is to notify that there may be criminal convictions, outstanding
charges, or pardoned sex offenses associated to the above name and
date of birth, the existence of which can only be confirmed by the
RCMP based on fingerprints.
This is to notify that the above person has been involved in notable
police incidents related to the five (5) year address history provided.
SEE ATTACHED DISCLOSURE
VOID without Ottawa Police seal
FOR POLICE USE OnLY
FORM #306/Rev. May 2010
PAGE 1 OF ___
PRInT CLEARLY. THIS WILL bE USED TO MAIL YOUR FORM bACK TO YOU.
Date Completed (yy/mm/dd): | |
(BY POLICE)
Signed:
POLICE AUTHORIZING SIGNATURE
The search includes national and local police databases with cooperating police services. The possible existence of criminal convictions and outstanding
charges, as well as incidents of all police contacts for the previous five years will be considered for release.
If an outside agency does not provide the police records checks, a stamp stating, “NO RESPONSE FROM POLICE SERVICE IN THIS AREA” will appear on page
one of this form. It is the responsibility of the applicant to contact the outside police agency to obtain a local police records check.
This search is intended for individuals seeking employment and/or a volunteer position with children or vulnerable person(s). Information is
collected and disclosed according to section 29(1) and 32 of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA) and
the Police Services Act, RSO 1990,c.P.15
InFORMATIOn FOR RELEASE
The following information contained in local police databases may be considered for release when it is deemed appropriate:
• Suspectinformation,wherethereleaseofsuchwillnothinderanyongoinginvestigation.
• ReportsresultingfromparticularincidentsrelatingtotheMentalHealthAct.
• Anynotablepolicecontact.
This search does not cover the following areas: discharges and pardons (with the exception of sexual offences listed in the schedule to the Criminal Records
Act). The information contained on this certificate is accurate on the date issued.
For more information, please visit our Web site at ottawapolice.ca
PROCEDURE
1. The Police Records Check Form must not be altered.
2. The applicant must produce two pieces of valid (i.e. not expired) identification that confirm his/her name, date of birth and address. One piece of
identification presented must include a photo. Ontario Health Cards cannot be accepted for identification purposes (Health Cards and Numbers Control
Act, 1991 section 2.2(1)). The following is a list of items that could be considered acceptable forms of identification.
Photo Identification:
which provides photo and both name and date of birth
of an individual:
*Driver’s Licence
Government Employment Card (with d.o.b.)
Military Employment Card
Age of Majority Card
Canadian Citizenship Card (up-to-date)
Indian Status Card
International Student Card
Passport
Permanent Resident Card
Possession and Acquisition Licence (PAL)
Canadian national Institute for blind (CnIb)
*Recent Utility bill required to verify current Ottawa address
if no Driver’s Licence is available.
non-Photo Identification:
which provides both the name and date of birth of an individual:
birth Certificate
baptismal Certificate
Hunting Licence
Fishing Licence
Outdoors Card
Hospital Card
Immigration Papers
3. If a person requesting the Records check is under the age of 16 years and does not have sufficient indentification a parent or legal guardian (with
proper ID) can guarantee the young person’s identity.
4. In the case of a possible match, individuals who require a copy of their criminal record, will have to be fingerprinted by the Ottawa Police Service by
appointment only. Please contact 613-236-1222 ext. 5485 for an appointment. The fee for this service is waived for volunteers. Fingerprints will be
forwarded by the OPS to the RCMP along with the applicant’s certified cheque or money order in the amount of $25 (payable to the Receiver General
of Canada). Results of the RCMP’s search will be mailed directly to the applicant. The RCMP fee is not required if the applicant provides written
confirmation of volunteer work from a bona fide registered non-profit organization.
5. Police Records Checks are processed in approximately 3-6 weeks, (exception: 6-8 weeks during peak periods) assuming timely response from other
police services and depending on request volumes.
6. The service fee can be waived if the applicant presents a letter from a local organization that intends to engage them in a volunteer capacity. The
letter must be provided on official letterhead, in original, it must include the name of the person requesting a Police Records Check and must be signed
by the manager in charge of volunteer resources. A non-resident surcharge applies to applicants residing outside OPS jurisdiction. An express
surcharge applies if service is to be performed on a “while you wait” basis (only possible if the applicant resided in Ottawa for the past five years).
SCREENING INSTRUCTIONS – POLICE RECORDS CHECK
For more information, please visit our Web site at ottawapolice.ca
