Criminal History Information Request
This is a local name based background check for Indian River County

I am requesting a criminal history record check on the following individual.	Date requested:			
Last Name:	First Name:		Middle Name:			
Other Names Used:	
Race:	.	Sex:	.	Date Of Birth:	
Social Security Number:	XXX-XX-	Address:				
Required Information
Last & First Name- Complete name of person	Sex- Male or Female	Date of Birth Race- White, Black, American Indian, Asian, Pacific Islander, Unknown or Other
Optional Information
Social Security Number, Middle name, Other Names Used, and Address
Payment Options
Personal or Business Check- Must include pre-printed name of account holder and mailing address.
Money Order- Must be made payable to U.S. Funds
Cash – Is accepted for requests made in person at the Sheriff’s Office.
All Payments must be made payable to Indian River County Sheriff's Office
Please mail this form along with the required $3 processing fee to:
Indian River County Sheriff's Office ATTN: Central Records
4055 41st Ave
Vero Beach, FL 32960
Return Criminal History Information Request Results To:
	Contact Person :	Street:	
	Contact Phone :	City:	
	Email:	State:	
	Fax:	Zip:	
	I will pick up the reports Within 30 Days.
*Please be advised that reports not picked up within 30 days will be shredded and a new request and payment will be required.	
		
Below is for Indian River County Sheriff’s Office Use Only