OREGON STATE POLICE FINGERPRINT BASED CRIMINAL BACKGROUND CHECK APPLICATION

OREGON STATE POLICE FINGERPRINT BASED CRIMINAL BACKGROUND CHECK APPLICATION Oregon State Police Clearinghouse Unit 3772 Portland Rd NE, Bldg C Salem, Oregon 97301 503-378-3070 FAX 503-378-2121 www.osp.clearinghouse@state.or.us CLEARINGHOUSE UNIT Revised 1/15

Fingerprint Based Background Checks This process is only available to Oregon-based organizations. Organizations outside of Oregon must use the Open Records service. For an organization to be able to use this service, the organization must comply with Oregon Revised Statute 181.533. ORS 181.533 reads: 181.533 Criminal records check; qualified entities; rules. (1) As used in this section: (a) Authorized agency means the Department of State Police or other governmental agency designated by the state to report, receive or disseminate criminal offender information. (b) Qualified entity means a business or organization that: (A) Provides care or placement services, or licenses or certifies others to provide care or placement services, for children, elderly persons or dependent persons; (B) Is not governed by a state regulatory or licensing agency; and (C) Has been determined by an authorized agency to meet the criteria established by the authorized agency by rule under subsection (9) of this section. (c) Subject individual means a person who is employed or seeks to be employed by a qualified entity or who is providing services or seeks to provide services to a qualified entity on a contractual or volunteer basis. (2) An entity may request from an authorized agency a criminal records check for purposes of evaluating the fitness of a subject individual as an employee, contractor or volunteer. The authorized agency may access state and federal criminal records under this subsection only through use of the subject individual s fingerprints. (3) Before an authorized agency may conduct a criminal records check under this section: (a) The authorized agency shall determine whether the entity requesting the criminal records check is a qualified entity; (b) The qualified entity must establish criteria to be used by the authorized agency in reviewing the criminal offender information for a final record check determination; (c) The qualified entity must provide the criteria established under paragraph (b) of this subsection to the authorized agency; and (d) The qualified entity must have informed the subject individual that the qualified entity might request a fingerprint-based criminal records check and that the subject individual may obtain a copy of the record check report from, or challenge the accuracy or completeness of the record check report through, the authorized agency or the Federal Bureau of Investigation. (4)(a) Upon receipt of a subject individual s criminal offender information, the authorized agency shall make a final record check determination by comparing the criminal offender information with the criteria provided to the authorized agency by the qualified entity under subsection (3)(c) of this section. In making the final record check determination, the authorized agency may consider only information that the Department of State Police may disclose under ORS 181.560. (b) An authorized agency is immune from civil liability that might otherwise be incurred or imposed for making the final record check determination under this Rev. 1/15 2

subsection. (5) An authorized agency may not transfer a fingerprint card used to conduct the criminal records check unless the public agency or person receiving the fingerprint card agrees to destroy or return the fingerprint card to the authorized agency. (6) If the public agency or person returns a fingerprint card to the authorized agency, the authorized agency shall destroy the fingerprint card. The authorized agency may not keep a record of the fingerprints. (7) The authorized agency shall permit a subject individual to inspect the individual s Oregon and Federal Bureau of Investigation criminal offender information after positive identification has been established based upon fingerprints. (8) Challenges to the accuracy or completeness of information provided by the authorized agency, the Federal Bureau of Investigation and agencies reporting information to the authorized agency or bureau must be made through the authorized agency or bureau. (9) The authorized agency shall adopt rules to implement this section. The rules may include but are not limited to: (a) Criteria to be used by the authorized agency to determine whether an entity is a qualified entity; and (b) Fees to be charged for conducting criminal records checks under this section in amounts not to exceed the actual costs of acquiring and furnishing criminal offender information. [2001 c.871 1] Qualifying organizations must complete, at a minimum, the Oregon Qualified Organization Fingerprint Based Application and Criminal Record Criteria Section in this packet. Once completed, these forms must be returned to Oregon State Police, Clearinghouse Unit at the address on the application. Before a fingerprint based criminal record check can be completed, the Oregon State Police must determine whether the organization requesting the criminal record check is a qualified organization. The qualified organization must establish criteria to be used by the Oregon State Police in reviewing the criminal offender information for a final record check determination. The qualified organization must provide the established criteria to the Oregon State Police. Once the account and fingerprint criteria have been established, the qualified organization may then submit fingerprints of their volunteers or employees. The appropriate fee to conduct the criminal background check must accompany each request. The Department of State Police charge $65.50 for a volunteer and $66.75 for an employee. The Oregon State Police will then conduct a fingerprint based criminal record background check of both the Oregon and FBI criminal history records. The Oregon State Police will make a final record check determination by comparing any criminal offender information found within the criteria provided by the qualified organization. Any subject individual that has been denied may challenge the accuracy and completeness of their record check through the Oregon State Police Clearinghouse Unit. Rev. 1/15 3

Oregon Qualified Organization Fingerprint Based Application Please complete this form along with the Criminal Record Criteria Selection sheet and mail to Oregon State Police, Clearinghouse Unit, 3772 Portland Road NE, Bldg C, Salem, Oregon 97301. Organization/Business Name: Mailing Address: Telephone Number: Fax Number: E-Mail Address: Contact Person: Is your organization regulated by any state agency? If so, which agency? Please describe your business/organization and how it interacts with children, the elderly or disabled persons. Rev. 1/15 4

Criminal Record Criteria Selection The Oregon State Police will use your criteria as the basis to decide if the person you are checking on is qualified. The Oregon State Police s response will be in letter form and merely state, approved or denied. You will not receive criminal offender information concerning the person you are checking on. The Oregon State Police will then destroy the fingerprint card. PLEASE CHECK THE OFFENSES THAT YOU WANT TO BE USED AS A DISQUALIFIER FOR YOUR ORGANIZATION ORGANIZATIONS MAY PUT TIME LIMITATIONS ON CHARGES. Example: Any Controlled Substance Conviction within the last 10 years. Write in any time limitations next to the charge(s) on which you wish to place limits. FOR ACTIVE WARRANTS CHECK THIS BOX FOR RESTRAINING ORDERS CHECK THIS BOX FOR SEX OFFENDER REGISTRATION CHECK THIS BOX FOR ANY FELONY CONVICTION CHECK THIS BOX FOR ANY MISDEMEANOR CONVICTION CHECK THIS BOX FOR ANY SEX OFFENSE CONVICTION CHECK THIS BOX FOR ANY CONTROLLED SUBSTANCE CONVICTION CHECK THIS BOX FOR THREE OR MORE CONVICTIONS OF ANY TYPE (shows pattern of behavior) CHECK THIS BOX FOR ANY CONVICTION OF ANY TYPE CHECK THIS BOX -OR- Your organization may use the following list of Oregon Criminal Charges as your criteria. Please check off the charges that your organization would like to use as their criteria for disqualifying the applicant. To find complete definitions of each charge go to: www.leg.state.or.us/ors Rev. 1/15 5

ORS OFFENSE CLASS Time Limit? F: Felony Charge If so How Long? Example: within last 10 years. 163.535 ABANDONMENT OF A CHILD F 166.087 ABUSE OF CORPSE 1ST DEG F 166.085 ABUSE OF CORPSE 2ND DEG F 167.322 AGGRAVATED ANIMAL ABUSE I F 253.710 ALTER APPL FOR ABSENTEE BALLOT F 166.450 ALTER IDENTIFICATION-FIREARMS F 247.125 ALTER VOTER REGISTRATION CARD F 164.325 ARSON 1ST DEG F 164.315 ARSON 2ND DEG F 163.185 ASSAULT 1ST DEG F 163.175 ASSAULT 2ND DEG F 163.165 ASSAULT 3RD DEG F 167.339 ASSAULT LAW ENFORCEMENT ANIMAL F 163.208 ASSAULT PUBLIC SAFETY OFFICER F 166.220 ATT USE/CARRY DANGEROUS F WEAPON 163.515 BIGAMY F 162.015 BRIBE GIVING F 162.025 BRIBE RECEIVING F 162.275 BRIBE RECEIVING BY WITNESS F 162.265 BRIBING A WITNESS F 164.225 BURGLARY 1ST DEG F 164.215 BURGLARY 2ND DEG F 163.537 BUY OR SELL PERSON UNDER 18 F 475.984 CAUSE PERSON-INGEST CONT SUBST F 165.581 CELLULAR COUNTERFEIT 1ST DEG F 165.579 CELLULAR COUNTERFEIT 2ND DEG F 167.167 CHEATING F 163.547 CHILD NEGLECT 1ST DEG F 163.275 COERCION F 506.991 COMM FISH OFFENSE-FELONY F 260.402 CONTRIBUTIONS IN FALSE NAME F 803.080 COUNTERFEIT VEHICLE TITLE F 165.022 CRIM POSS FORG INST 1ST DEG F 165.032 CRIM POSS OF FORGERY DEVICE F 162.367 CRIMINAL IMPERSONATE PEACE F OFFICER 164.365 CRIMINAL MISCHIEF 1ST DEG F 163.205 CRIMINAL MISTREATMENT 1ST DEG F 163.555 CRIMINAL NONSUPPORT F 163.145 CRIMINALLY NEGLIGENT HOMICIDE F 163.257 CUSTODIAL INTERFERENCE 1ST DEG F 163.245 CUSTODIAL INTERFERENCE 2ND DEG F 161.725 DANGEROUS OFFENDER F Rev. 1/15 6

163.670 DISPLAY CHILD-SEXUAL CONDUCT F 314.835 DIVULGE TAX RETURN INFO F 167.365 DOGFIGHTING F 163.684 ENCOURAGE CHILD SEX ABUSE 1ST F 163.686 ENCOURAGE CHILD SEX ABUSE 2ND F 164.885 ENDANGERING AIRCRAFT F 164.172 ENGAGE FINANCIAL TRANS-UNL ACT F 468.951 ENVIRONMENTAL ENDANGERMENT F 162.165 ESCAPE 1ST DEG F 162.155 ESCAPE 2ND DEG F 162.205 FAIL TO APPEAR 1ST DEG F 131.675 FAIL TO GIVE AID-RIOT F 165.692 FALSE CLAIM HEALTHCARE PAYMENT F 260.555 FALSE STATEMENT-PETITION F 822.605 FALSE SWEARING-VEH BUSN CERT F 166.270 FELON IN POSSESSION OF WEAPON F 166.642 FELON POSSESS BODY ARMOR F 163.207 FEMALE GENITAL MUTILATION F 532.140 FOREST PROD BRAND OFF-FELONY F 803.230 FORGE/ALTER VEHICLE TITLE/REG F 165.013 FORGERY 1ST DEG F 166.429 FURNISH FIREARM USED IN FELONY F 162.325 HINDERING PROSECUTION F 811.705 HIT AND RUN-VEHICLE-INJURY F 165 800 IDENTITY THEFT F 163.525 INCEST F 166.165 INTIMIDATION 1ST DEG F 163.235 KIDNAPPING 1ST DEG F 163.225 KIDNAPPING 2ND DEG F 164.170 LAUNDER MONETARY INSTRUMENT F 163.118 MANSLAUGHTER 1ST DEG F 163.125 MANSLAUGHTER 2ND DEG F 166.410 MANU/IMPORT/SELL-FIREARMS F 166.384 MANUFACTURE DESTRUCTIVE DEVICE F 163.115 MURDER F 163.095 MURDER-AGGRAVATED F 811.127 ORGANIZING SPEED RACING EVENT F 144.350 PAROLE VIOLATION F 162.065 PERJURY F 165.070 POSS FRAUDULENT COMM DEVICE F 167.137 POSS GAMBLING RECORDS 1ST DEG F 097.745 POSS INDIAN ARTIFACTS-REMAINS F 163.688 POSS MAT/SEX COND CHILD 1ST DEG F 163.689 POSS MAT/SEX COND CHILD 2ND DEG F 475.967 POSS SUBST W/INTENT TO MANUF F 166.382 POSSESS DESTRUCTIVE DEVICE F 166.370 POSSESS FIREARM/DEVISE-PUB BLD F 166.272 POSSESS PROHIBITED FIREARM F 819.300 POSSESS STOLEN VEHICLE F 166.275 POSSESSION OF WEAPON BY INMATE F Rev. 1/15 7

144.108 POST PRISON SUPV SANCTION F 677.080 PRACTICE MEDICINE W/O LICENSE F 109.311 PROHIBITED FEES-ADOPTION F 167.017 PROSTITUTION-COMPELLING F 167.012 PROSTITUTION-PROMOTING F 162.117 PUBLIC INVESTMENT FRAUD F 166.720 RACKETEERING F 163.375 RAPE 1ST DEG F 163.365 RAPE 2ND DEG F 163.355 RAPE 3RD DEG F 166.015 RIOT F 164.415 ROBBERY 1ST DEG F 164.405 ROBBERY 2ND DEG F 164.395 ROBBERY 3RD DEG F 059.135 SECURITIES FRAUD F 163.427 SEXUAL ABUSE 1ST DEG F 163.425 SEXUAL ABUSE 2ND DEG F 163.411 SEXUAL PEN W/OBJECT 1ST DEG F 163.408 SEXUAL PEN W/OBJECT 2ND DEG F 162.355 SIMULATING LEGAL PROCESS F 163.405 SODOMY 1ST DEG F 163.395 SODOMY 2ND DEG F 163.385 SODOMY 3RD DEG F 165.090 SPORTS BRIBE RECEIVING F 165.085 SPORTS BRIBERY F 433.010 SPREAD COMMUNIC DISEASE F 411.675 SUBM FALSE CLAIM/BILL-PUB ASST F 815.430 SUBMIT FALSE ODOMETER READING F 468.953 SUPPLY FALSE INFO-ENVIRONMENTAL F 162.185 SUPPLYING CONTRABAND F 260.645 TAMPER/INJURE VOTING MACHINE F 162.285 TAMPERING WITH A WITNESS F 167.212 TAMPERING WITH DRUG RECORDS F 314.075 TAX EVASION F 164.055 THEFT 1ST DEG F 164.057 THEFT 1ST DEG - AGGRAVATED F 164.075 THEFT BY EXTORTION F 260.575 THREATEN/EXTORT-PETITION F 166.651 THROW OBJ OFF OVERPASS I F 647.150 TRADEMARK COUNTERFEIT 1ST DEG F 647.145 TRADEMARK COUNTERFEIT 2ND DEG F 819.310 TRAFFICK IN STOLEN VEHICLES F 166.005 TREASON F 164.135 UNAUTHORIZED USE MOTOR VEHICLE F 260.665 UNDUE INFLUENCE F 468.926 UNL DISP/STOR/TRT HAZ WASTE 1ST F 165.813 UNL POSSESS FICTITIOUS ID F 165.810 UNL POSSESS PERSONAL ID DEVICE F 468.931 UNL TRANSPORT HAZ WASTE 1 F 468.946 UNLAW WATER POLLUTION 1ST DEG F Rev. 1/15 8

468.939 UNLAWFUL AIR POLLUTION 1ST DEG F 165.074 UNLAWFUL FACTORING CREDIT CARD F 167.127 UNLAWFUL GAMBLING 1ST DEG F 164.868 UNLAWFUL LABEL SOUND RECORDING F 411.630 UNLAWFUL OBT PUBLIC ASSISTANCE F 815.410 UNLAWFUL ODOMETER TAMPERING F 166.660 UNLAWFUL PARAMILITARY ACTIVITY F 166.643 UNLAWFUL POSSESS BODY ARMOR F 411.640 UNLAWFUL REC PUBLIC ASSISTANCE F 167.164 UNLAWFULL POSSESS GRAY MACHINE F 411.840 UNLAWFULLY OBT/USE FOOD STAMPS F 059.165 UNLICENSED SECURITY TRANSACTION F 059.055 UNREGISTERED SECURITIES F 163.213 USE STUN GUN/TEAR GAS/MACE 1ST F 260.715 VIOLATE ELECTION LAWS-GENERAL F 496.992 WILDLIFE OFFENSE-FELONY F M: Misdemeanor Charge 166.076 ABUSE MEMORIAL TO DEAD M 166.075 ABUSE VENERATED OBJECT M 165.490 AGENT USE INFO-TELEGRAPH MSG M 471.412 ALLW INTOX PERS TO CONSUME LIQ M 815.305 ALTER POLLUTION CONTROL SYSTEM M 165.485 ALTER TELEGRAPHIC MESSAGE M 167.340 ANIMAL ABANDONMENT M 167.315 ANIMAL ABUSE 2ND DEG M 167.355 ANIMAL FIGHTING-INVOLVEMENT M 167.330 ANIMAL NEGLECT 1ST DEG M 167.325 ANIMAL NEGLECT 2ND DEG M 830.035 ATT TO ELUDE POLICE OFC-BOAT M 165.515 BRIBERY OF TELEGRAPH AGENT M 701.055 BUILDER REGISTRATION OFFENSE M 477.515 BURN W/O PERMIT-FOREST LAND M 166.250 CARRY CONCEALED/POSS FIREARM M 166.240 CARRY CONCEALED/POSS KNIFE M 165.577 CELLULAR COUNTERFEIT 3RD DEG M 163.545 CHILD NEGLECT 2ND DEG M 221.926 CITY ORDINANCE OFFENSE M 509.006 COMM FISH OFFENSE-MISDEMEANOR M 162.335 COMPOUNDING A FELONY M 167.820 CONCEALING BIRTH OF AN INFANT M 475.994 CONT SUB OFF-REGISTRANT RECORD M 033.045 CONTEMPT OF COURT M 163.435 CONTRIB SEX DELINQUENCY-MINOR M 807.500 COUNTERFEIT LICENSE FORMS M 203.035 COUNTY ORDINANCE OFFENSE M 167.810 CREATE HAZARD-RFG/WELL/HOLE M 165.017 CRIM POSS FORG INST 2ND DEG M Rev. 1/15 9

164.243 CRIM TRESPASS 2ND DEG-GUEST M 164.265 CRIM TRESPASS-POSSESS FIREARM M 164.278 CRIM TRESPASS-SPORTS EVENT M 164.354 CRIMINAL MISCHIEF 2ND DEG M 164.345 CRIMINAL MISCHIEF 3RD DEG M 163.200 CRIMINAL MISTREATMENT 2ND DEG M 165.037 CRIMINAL SIMULATION M 164.255 CRIMINAL TRESPASS 1ST DEG M 164.245 CRIMINAL TRESPASS 2ND DEG M 164.825 CUT/TRANS CONIFEROUS TREES M 164.813 CUT/TRANS MINOR FOREST PRODUCT M 475.991 DEL IMITATION CONT SUBSTANCE M 476.715 DEP LIGHTED MATERIAL-LAND/HWY M 164.775 DEPOSIT TRASH W/IN 100YD WATER M 166.635 DISCHARGE WEAPON/OBJECT-TRAIN M 166.638 DISCHARGE WEAPON-AIRPORT M 132.420 DISCLOSURE OF INDICTMENT M 166.025 DISORDERLY CONDUCT M 167.080 DISPLAY OBSCENE MATERIAL-MINOR M 167.087 DISSEMINATE OBSCENE MATERIAL M 609.095 DOG AS PUBLIC NUISANCE M 167.370 DOGFIGHTING-PARTICIPATE M 163.687 ENCOURAGE CHILD SEX ABUSE 3RD M 163.575 ENDANGERING WELFARE OF MINOR M 477.550 ENTER CLOSED AREA-FIRE HAZARD M 162.145 ESCAPE 3RD DEG M 462.080 EXCLU CERTAIN PERS RACE COURSE M 131.725 EXCLUSION FROM PUBLIC PROPERTY M 167.075 EXHIBIT OBSCENE PERFORM-MINOR M 807.570 FAIL CARRY/PRESENT OP LICENSE M 803.225 FAIL DESIGNATE ASSEMBLE VEH M 682.047 FAIL DISPLAY AMBULANCE CERT M 165.109 FAIL MAINTAIN CEDAR RECORD M 165.107 FAIL MAINTAIN METAL RECORD M 819.018 FAIL NOTIFY PURCHASER-VEH COND M 163.693 FAIL REPORT CHILD PORNOGRAPHY M 475.955 FAIL REPORT MISSING PRECURSOR M 475.950 FAIL REPORT PRECURSOR TRANS M 822.535 FAIL RET SUSP TRN INST CERT M 822.520 FAIL RET SUSP TRN SCHOOL CERT M 822.055 FAIL RETURN SUSP DEALER CERT M 809.080 FAIL RETURN SUSP REGISTRATION M 822.150 FAIL RETURN SUSP WRECKER CERT M 809.500 FAIL RETURN SUSPENDED OP LIC M 822.325 FAIL RETURN VEHICLE TRANS CERT M 815.425 FAIL SUBMIT ODOMETER READING M 805.360 FAIL SURRENDER FARM REG PLATE M 806.300 FAIL SURRENDER LICENSE/REG M 809.110 FAIL SURRENDER REGIS/TITLE M 162.195 FAIL TO APPEAR 2ND DEG M Rev. 1/15 10

133.076 FAIL TO APPEAR-CRIM CITATION M 164.845 FAIL TO APPEAR-FOREST PROD CIT M 153.064 FAIL TO APPEAR-VIOL M 818.400 FAIL TO COMPLY-COMMERCIAL VEH M 819.010 FAIL TO COMPLY-VEH DESTRUCTION M 358.950 FAIL TO NOTIFY INDIAN TRIBE M 146.100 FAIL TO NOTIFY OF DEATH M 819.420 FAIL TO OBTAIN VEHICLE VIN M 161.685 FAIL TO PAY FINE M 137.128 FAIL TO PERFORM COMM SERVICE M 811.740 FALSE ACCIDENT REPORT M 682.028 FALSE APPL-AMBULANCE/EMT CERT M 807.530 FALSE APPLICATION-OP LICENSE M 803.375 FALSE APPL-VEH REGISTRATION M 806.030 FALSE CERT-FARM RESP EXEMP M 815.320 FALSE CERT-POLLUTION CONT SYST M 806.055 FALSE INFO ABOUT LIABIL INSUR M 830.730 FALSE INFO TO MARINE BOARD M 166.416 FALSE INFO/TRANSFER FIREARM M 162.385 FALSE INFO-POLICE OFC-CRIM OFF M 807.620 FALSE INFO-POLICE OFC-VEH OFF M 475.965 FALSE INFO-PRECURSOR REPORT M 162.375 FALSE REPORT - INITIATING M 704.030 FALSE STAT REGIST APP-BOAT M 656.990 FALSE STATEMENT TO OBT BENEFIT M 803.070 FALSE STATEMENT-VEHICLE TITLE M 162.075 FALSE SWEARING M 805.370 FALSE SWEARING-FARM REGIS M 807.520 FALSE SWEARING-OP LICENSE M 803.075 FALSE SWEARING-VEHICLE TITLE M 803.385 FALSE SWEAR-VEH REGISTRATION M 471.135 FALSE WRITTEN STATEMENT OF AGE M 475.981 FALSIFY DRUG TEST RESULTS M 806.050 FALSIFY FINAN RESPONSIBILITY M 165.080 FALSIFYING BUSINESS RECORDS M 480.120 FIREWORKS OFFENSE M 477.650 FOREST FIRE PROTECTION OFFENSE M 532.130 FOREST PROD BRAND OFF-MISD M 527.710 FORESTRY RULE VIOLATION M 165.007 FORGERY 2ND DEG M 165.042 FRAUDULENTLY OBTAIN SIGNATURE M 167.222 FREQ PLACE CONTROLLED SUB USED M 128.821 FUND RAISING OFFENSE M 167.065 FURNISH OBSCENE MATERIAL-MINOR M 471.410 GIVE LIQUOR-MINOR/INTOX PERSON M 166.065 HARASSMENT M 811.700 HIT AND RUN-VEHICLE-PROPERTY M 821.260 HUNT FROM SNOMO/CLASS I VEH M 166.645 HUNT IN CEMETERY M 475.960 ILLEGALLY SELL DRUG EQUIPMENT M Rev. 1/15 11

166.418 IMPROPER TRANSFER FIREARM M 165.570 IMPROPER USE OF 911 M 165.543 INTERCEPTION OF COMMUNICATIONS M 162.247 INTERFERE W/ PEACE OFFICER M 164.887 INTERFERE W/AGRICULTURAL OP M 162.455 INTERFERE W/LEGISLATIVE OPER M 165.572 INTERFERE W/MAKING A REPORT M 166.116 INTERFERE W/PUBLIC TRANSPORT M 162.257 INTERFERE WITH FIREFIGHTER M 164.369 INTERFERING WITH POLICE ANIMAL M 166.155 INTIMIDATION 2ND DEG M 163.700 INVASION OF PERSONAL PRIVACY M 166.300 KILL ANOTHER-LOSE RT BEAR ARMS M 215.190 LAND USE OFFENSE M 671.530 LANDSCAPING LICENSE OFFENSE M 165.510 LEARN CONTENT OF TELEGRAPH MSG M 607.045 LIVESTOCK AT LARGE M 604.071 LIVESTOCK BRAND OFFENSE M 164.162 MAIL THEFT M 471.620 MAINT COMMON NUISANCE-LIQUOR M 165.100 MAKE FALSE FINANCIAL STATEMENT M 607 261 MALE STOCK AT LARGE-OPEN RANGE M 616.215 MAN/SALE/DEL ADULTERATED FOOD M 163.190 MENACING M 165.095 MISAPPLY ENTRUSTED PROPERTY M 166.095 MISCONDUCT-EMERGENCY TELE CALL M 471.130 MISREP AGE BY A MINOR-LIQUOR M 165.805 MISREPRESENT AGE BY A MINOR M 609.805 MISREPRESENTATION OF PEDIGREE M 162.425 MISUSE CONFIDENTIAL INFO M 807.430 MISUSE OF IDENT CARD M 471.360 MIX-SELL-SERVE LIQ/NO PERMIT M 146.103 MOVE BODY/EFFECTS-CRIME SCENE M 166.180 NEGLIGENTLY WOUNDING ANOTHER M 682.051 NO AMBULANCE CERTIFICATION M 690.015 NO BARBER/HAIRDRESSERS LICENSE M 830.435 NO CHARTER BOAT LICENSE M 822.500 NO COMM VEH TRN SCHOOL CERT M 476.380 NO COUNTY FIRE PERMIT M 478.960 NO DISTRICT FIRE PERMIT M 822.525 NO DRIVER TRN INSTRUCTOR CERT M 682.204 NO EMT-I CERTIFICATION M 609.319 NO EXOTIC ANIMAL PERMIT M 480.210 NO EXPLOSIVE PERMIT M 446.320 NO LIC FOR TOURIST FACILITY M 471.403 NO LIC-BREW/DISTILL LIQUOR M 687.021 NO MASSAGE BUSINESS LICENSE M 696.020 NO REAL ESTATE LICENSE M 624.020 NO RESTAURANT LICENSE M 822.005 NO VEHICLE DEALER CERTIFICATE M Rev. 1/15 12

822.100 NO WRECKING BUSN CERTIFICATE M 162.235 OBSTRUCT GOV/JUDICIAL ADMIN M 165.540 OBT CONTENTS OF COMMUNICATIONS M 165.102 OBTAIN DOCUMENT BY DECEPTION M 164.805 OFFENSIVE LITTERING M 162.415 OFFICIAL MISCONDUCT 1ST DEG M 162.405 OFFICIAL MISCONDUCT 2ND DEG M 830.325 OP BOAT UNDER INFLUENCE INTOX M 165.505 OPEN TELEGRAPH MSG OF ANOTHER M 165.520 OPEN/READ/PUBLISH LETTER M 443.725 OPER FOSTER HOME W/O LIC M 443.410 OPER RESID FACILITY W/O LIC M 704.020 OUTFITTER/GUIDE OFFENSE M 498.153 PARK VEHICLE-VIOL RESTRICTION M 726.020 PAWNBROKERS ACT OFFENSE M 690.355 PERFORM TATTOO/ELECTR W/O LIC M 807.590 PERMIT MISUSE OF OP LICENSE M 634.372 PESTICIDE CONTROL OFFENSE M 164.785 PLACE OFF SUB-WATER/HWY/PROP M 166.190 POINTING FIREARM AT ANOTHER M 167.132 POSS GAMBLING RECORDS 2ND DEG M 166.350 POSSESS ARMOR PIERCING AMMO M 164.235 POSSESS BURGLARS TOOLS M 162.369 POSSESS FALSE LAW ENFORCE ID M 689.765 POSSESS FEDERAL LEGEND DRUG M 480.070 POSSESS FIRE BOMB M 167.147 POSSESS GAMBLING DEVICE M 471.478 POSSESS UNLABELED BEER KEG M 686.020 PRACTICE VET MED W/OUT LICENSE M 163.467 PRIVATE INDECENCY M 137.545 PROBATION VIOLATION M 830.460 PROHIB ACTIVITIES-CHARTER BOAT M 358.920 PROHIB CONDUCT-ARCHAEOLOGICAL M 459.247 PROHIB DISPOSAL SOLID WASTE M 837.080 PROHIB OPERATION OF AIRCRAFT M 167.007 PROSTITUTION M 133.318 PROVIDE FALSE FOREIGN REST ORD M 475.805 PROVIDE HYPODERMIC TO MINOR M 167.090 PUBLICLY DISPLAY NUDITY/SEX M 033.065 PUNITIVE CONTEMPT OF COURT M 164.335 RECKLESS BURNING M 811.140 RECKLESS DRIVING M 811.231 RECKLESS ENDANGER HWY WORKER M 830.315 RECKLESS OPERATION OF BOAT M 163.195 RECKLESSLY ENDANGERING M 813.095 REFUSAL TO TAKE BREATH TEST M 165.495 REFUSE SEND/DEL TELEGRAPH MSG M 166.427 REGISTER TRANSFER USED FIREARM M 033.055 REMEDIAL CONTEMPT OF COURT M 196 810 REMOVE MATERIAL WITHOUT PERMIT M Rev. 1/15 13

815.420 REMOVE ODOMETER REPAIR NOTICE M 162.315 RESISTING ARREST M 374.305 ROAD RIGHT OF WAY OFFENSE M 167.502 SALE ITEMS-UNUSED PROP MARKET M 475.525 SALE OF DRUG PARAPHERNALIA M 165.825 SELL DRUGGED HORSE M 807.510 SELL FALSE DOCUMENTS-LIC/REG M 803.085 SELL UNTITLED VEHICLE M 166.480 SELL/DEL EXPL/FIREARM TO CHILD M 167.070 SEND OBSCENE MATERIAL TO MINOR M 471.475 SERVE LIQUOR WITHOUT LICENSE M 476.710 SET FIRE ON OCEAN SHORE M 166.320 SETTING SPRINGGUN OR SETGUN M 163.415 SEXUAL ABUSE 3RD DEG M 167.333 SEXUAL ASSAULT OF ANIMAL M 163.445 SEXUAL MISCONDUCT M 163.187 STRANGULATION M 033.096 SUMMARY CONTEMPT OF COURT M 164.373 TAMPER W/CABLE TV EQUIPMENT M 162.295 TAMPERING WITH EVIDENCE M 166.090 TELEPHONIC HARASSMENT M 164.045 THEFT 2ND DEG M 164.043 THEFT 3RD DEG M 166.649 THROW OBJ OFF OVERPASS II M 167.351 TRADE NONAMBULATORY LIVESTOCK M 647.140 TRADEMARK COUNTERFEIT 3RD DEG M 819.430 TRAFFICK VEH W/ALTERED VIN M 167.385 UNAUTH USE LIVESTOCK ANIMAL M 162.175 UNAUTHORIZED DEPARTURE M 163.709 UNL DIRECT LIGHT/LASER POINTER M 468.922 UNL DISP/STOR/TRT HAZ WASTE 2ND M 475.973 UNL POSS/DISTRIBUTE EPHEDRINE M 475.971 UNL POSSESS ANHYDROUS AMMONIA M 468.929 UNL TRANSPORT HAZ WASTE 2 M 815.095 UNLAW POLLUTION CONTROL SYSTEM M 471.405 UNLAW SELL/TRANS/IMPORT LIQUOR M 165.555 UNLAW TELEPHONE SOLICITATION M 468.943 UNLAW WATER POLLUTION 2ND DEG M 468.936 UNLAWFUL AIR POLLUTION 2ND DEG M 477.710 UNLAWFUL CAMPFIRE M 822.065 UNLAWFUL CONSIGNED VEH TRANSFER M 822.060 UNLAWFUL CONSIGNMENT PRACTICE M 146.121 UNLAWFUL DISPOSAL OF BODY M 164.132 UNLAWFUL DIST CABLE TV EQUIP M 164.272 UNLAWFUL ENTRY INTO MOTOR VEH M 146.107 UNLAWFUL ENTRY-CRIME SCENE M 167.122 UNLAWFUL GAMBLING 2ND DEG M 162.465 UNLAWFUL LEGISLATIVE LOBBYING M 815.415 UNLAWFUL ODOMETER REPAIR M 167.808 UNLAWFUL POSSESS INHALANTS M Rev. 1/15 14

475.975 UNLAWFUL POSSESS IODINE M 475.976 UNLAWFUL POSSESS IODINE MATRIX M 475.969 UNLAWFUL POSSESS PHOSPHORUS M 166.425 UNLAWFUL PURCHASE OF FIREARM M 166.470 UNLAWFUL SELL/DEL FIREARM M 164.865 UNLAWFUL SOUND RECORDING M 822.200 UNLAWFUL TOWING BUSINESS M 164.863 UNLAWFUL TRANS MEAT CARCASSES M 164.815 UNLAWFUL TRANSPORT OF HAY M 477.740 UNLAWFUL USE OF FIRE M 537.535 UNLAWFUL USE OF GROUND WATER M 822.070 UNLAWFUL VEH REBUILD BUSINESS M 819.040 UNLAWFUL VEHICLE SALVAGE M 164.875 UNLAWFUL VIDEOTAPE RECORDING M 819.270 UNLAWFULLY OPER JUNK VEHICLE M 480.215 UNLAWFULLY TRANSFER EXPLOSIVES M 165.047 UNLAWFULLY USING SLUGS M 418.215 UNLICENSED CHILD-CARING AGENCY M 815.232 UNREASONABLE SOUND AMP/VEHICLE M 162.085 UNSWORN FALSIFICATION M 807.600 USE ANOTHERS OPERATORS LICENSE M 166.330 USE FIREARM-INCUMBUST WADDING M 453.867 USE ILLEGAL DRUG MANUF SITE M 807.580 USE INVALID OPERATORS LICENSE M 453.885 USE OF CONTAMINATED PROPERTY M 163.212 USE STUN GUN/TEAR GAS/MACE 2ND M 453.882 USE UNFIT PROPERTY M 540.710 USE WATER DENIED/WATERMASTER M 811.060 VEH ASSLT BICYCLIST-PEDESTRIAN M 822.045 VEHICLE DEALER OFFENSE M 813.050 VIOL OUT-OF -SERVICE ORDER M 818.040 VIOL POSTED WEIGHT LIMIT M 805.350 VIOLATE FARM REGIS LIMITS M 135.290 VIOLATION OF RELEASE AGREEMENT M 498.002 WILDLIFE OFFENSE-MISDEMEANOR M 822.135 WRECKING BUSINESS OFFENSE M : Could be either a Misd or Felony charge 167.320 ANIMAL ABUSE 1ST DEG 475.986 APPLY CONT SUBST TO MINOR 163.160 ASSAULT 4TH DEG 811.540 ATT ELUDE POLICE OFC-VEHICLE 161.405 ATTEMPT TO COMMIT CRIME 164.377 COMPUTER CRIME 475.993 CONT SUBSTANCE OFF-REGISTRANT 475.992 CONTROLLED SUBSTANCE OFFENSE 164.140 CRIM POSS RENTED/LEASED PROP 161.450 CRIMINAL CONSPIRACY Rev. 1/15 15

811.182 CRIMINAL DRIVING-SUSP/REVOKED 162.365 CRIMINAL IMPERSONATION 475.995 DELIVER CONT SUBSTANCE-MINOR 471.440 DISTILL LIQUOR-POSSESS MASH 813.010 DRIVE UNDER INFLUENCE INTOX 181.599 FAIL TO REGISTER/SEX OFFENDER 165.055 FRAUDULENT USE OF CREDIT CARD 133.747 FUGITIVE FROM OTHER STATE 830.475 HIT AND RUN-BOAT 167.388 INTERFERE LIVESTOCK PRODUCTION 475.999 MAN/DEL CONTROL SUB-1000 FT SCH 165.065 NEGOTIATING A BAD CHECK 166.385 POSSESS HOAX DESTRUCT DEVICE 163.465 PUBLIC INDECENCY 167 312 RESEARCH/ANIMAL INTERFERENCE 167.062 SADO ABUSE SEX COND-LIVE SHOW 161.435 SOLICITATION TO COMMIT CRIME 163.732 STALKING 162.305 TAMPER WITH PUBLIC RECORDS 164.125 THEFT OF SERVICES 166.438 TRANSFER FIREARMS-GUN SHOWS 167.262 USING MINOR-CONTROL SUB OFF 496.992 WILDLIFE OFFENSE Rev. 1/15 16

Some non-profit organizations may qualify for a fee reduction. If your organization has a non-profit 501 (c) status and meets all of the following criteria, you may want to contact the Clearinghouse Unit for further instructions. 1. The person you are conducting a background check on must be a volunteer. 2. The person you are conducting a background check on must be mentoring or tutoring a youth, dependent person, or elderly person. 3. The person you are conducting a background check on must be in the mentoring or tutoring relationship with the youth, dependent person, or elderly person typically for nine months or longer. 4. The person you are conducting background checks on must be in a ONE-to-ONE relationship with the youth, dependent person or elderly person. (The relationship cannot be in a group setting). (A youth is a person who has not attained 18 years of age. A dependent person is a person who, because of physical or mental disability, or medical disability due to alcohol or drug dependence, needs mentoring or tutoring programs. An elderly person is a person 65 years of age or older.) Rev. 1/15 17