Criminal Records Release Form |
Complete the following release and Fax to the
Staftrack Data Center |
I hereby authorize Staftrack, Inc. to act as my agent for the purpose of receiving this criminal |
history record information pertaining to me which may be in the files of any state or local |
criminal justice agency. |
Full Name (printed) |
Address |
City, State, Zip |
Social Security Number |
Date of Birth |
Race | Sex |
Signature | Date:____/____/______ |
Staftrack, Inc.
P.O. Box 1133
Largo, Florida 33779
Phone 727-581-3603 Fax 727-581-3725
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Copyright StafTrack.
Last revised: August 08, 2015