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The DJ-LE-250A form, designed by the Wisconsin Department of Justice, facilitates requests for criminal history checks on multiple individuals. This form is essential for various entities, including government agencies, nonprofits, and the general public, allowing them to request background checks for a set fee. Properly completing the form ensures that the request is processed smoothly. Key components include the requestor type, purpose of the inquiry, and required personal information, such as name, date of birth, and sometimes social security numbers. Each completed request must include a self-addressed, postage-paid envelope and the total payment, which varies based on the nature of the request. Individuals can submit requests for general information, caregiver background checks, or specific additional processing when necessary. Wisconsin statutes ensure that the criminal history data available to the public excludes juvenile records unless authorized. The results are typically returned within ten business days, providing transparency and accessibility for those seeking information about potential criminal records.

Form Sample

DJ-LE-250A (Rev. 1/21)

STATE OF WISCONSIN

DEPARTMENT OF JUSTICE



DIVISION OF LAW ENFORCEMENT SERVICES

Crime Information Bureau

Record Check Unit

WISCONSIN CRIMINAL HISTORY

MULTIPLE NAME RECORD REQUEST

PO Box 2688

Madison, WI 53701-2688 608/266-7314

A self-addressed, postage-paid envelope must accompany every inquiry. Ensure sufficient postage is included. See next page for more information/instructions.

Return request

 

 

 

 

 

 

 

To :

__________________________________________ Attn: ____________________________

Phone: _____________________________

Street:

______________________________________________________________________________

FAX:

_____________________________

City, State,

 

 

 

 

 

 

 

Zip:

____________________________________________________________________ E-mail: _______________________________________

Requestor Type Check One

Request Purpose - Check One

Total Number of

 

Payment Type Check One

Government Agency$12.00*

General Information

Requests Submitted

Bill Account

General Public

$12.00*

Public Housing

 

 

 

 

Number #____________

Nonprofit Org.

$12.00*

Caregiver – General (*Add $3 DHS fee)

 

 

 

 

Amount

Public Defender (Fee Exempt)

Child Day Care - Caregiver (*Add $3 DHS fee)

 

 

 

 

Enclosed $____________

 

 

 

 

SPD # _______________________

Provide either Facility # _____________

Multiply the Search Fee (including DHS fee) times

 

 

 

or Certifying Agency # ______________

the Number of Requests to determine the amount to enclose

* Last Name

* First Name

Middle

* Sex * Race

*Date of Birth

(MM/DD/YYYY)

Other Identifying Data

(Soc Sec Num, Maiden name)

**CIB Use Only

(Leave Blank)

*Required Data – Please type or print legibly

**CIB will indicate “No Record” or will record the State Identification Number of the corresponding record in this column. The record(s) will be attached to this form and returned.

General Instructions

Use form DJ-LE-250A to request criminal background checks on more than one individual. Use form DJ-LE-250 to request background checks on a single individual. Wisconsin Statutes 19.35(1) and

165.82provide that any person or entity may request a criminal background check. The subject of the inquiry may be any person. Wisconsin adult criminal history data held by the Crime Information Bureau is public information. Wisconsin does not release juvenile information unless statutorily authorized.

The Wisconsin Criminal History Record Request must provide:

(1)Complete the “Return request to” section.

(2)Requestor Type. Check the box for your requestor type. Nonprofit organizations must include a copy of your 501(c)3 from the IRS.. Public defenders must include your SPD number.

(3)Request Purpose. Check the “General Information” box unless you need the special processing described below. Requests received without a purpose checked will be processed as General. Caregiver Background Check processing should be used by entities or individuals required to do caregiver background checks under s. 50.065, and child care entities under s. 48.685. The caregiver background check includes a Wisconsin criminal background check, a license and registry check from the Wisconsin Department of Health Services (DHS) and a professional credential check from the Wisconsin Department of Regulation and Licensing (DRL). The results of the caregiver background check from DHS/DRL are returned separately from the Wisconsin criminal history results. Child day care providers with day care facility numbers (assigned by the Division of Children and Families (DCF)) or with certifying agency numbers (assigned by the Wisconsin Department of Workforce Development (DWD)) must check the “Child Day Care” box and provide their facility or agency number. All other entities and individuals covered by the Caregiver legislation must check the “Caregiver Background Check – General” box.

(4)Enter the number of requests.

(5)Payment Type. Wisconsin s. 165.82 requires CIB to charge a fee for background checks. If you have an account and wish to be billed, enter your account number. Account customers will be billed monthly. A check or money order must accompany all other requests. Multiply the fee amount times the number of requests to determine the amount to enclose. If appropriate, include DHS Caregiver fee in Amount Enclosed. Make checks payable to the Wisconsin Department of Justice.

(6)Enter the complete name, sex, race, and date of birth for each individual being checked. Entry of social security number is optional, but please be aware that this number is one of the unique identifiers used by the Crime Information Bureau and by the Department of Health Services. Social Security numbers help prevent incorrect matches.

(7)A self-addressed, postage-paid envelope must accompany every inquiry. Ensure sufficient postage is included. This form will be returned and stamped “No Record” if there is no public criminal information on file at CIB. The form will be accompanied by public criminal history information if a record is found. Please allow 10 business days for the CIB record check and reasonable mailing time by the postal service. Do not provide an additional envelope for Caregiver results. General Caregiver results will be returned to the address specified in the “Return request to” section and Child Daycare results will be returned to the address on file at DHS or DWD.

Mail requests to:

Crime Information Bureau, Attn: Record Check Unit, PO Box 2688, Madison, WI 53701-2688

165.82CRIMINAL HISTORY SEARCH FEE. (1) Notwithstanding ss. 19.35(3) the Department of Justice shall impose the following fees, plus any surcharge required under sub. (1m), for criminal history searches for purposes unrelated to criminal justice:

(a)For each record check, except a fingerprint card record check, requested by a nonprofit organization, $7.00.

(ag) For each record check, except a fingerprint card record check, requested by a governmental agency, $7.00. (ar) For each fingerprint card record check requested by a governmental agency, $15.

(b) For each record check by any other requestor, $7.00.

(1m) The Department of Justice shall impose a $5 surcharge if a person requests a paper copy of a criminal history search requested under sub. (1).

(2)The Department of Justice shall not impose fees for criminal history searches for purposes related to criminal justice.

1999 WISCONSIN ACT 9 This act authorizes the Department of Health Services to impose a fee for caregiver checks submitted to that agency. This fee has been set at $3 and is effective April 1, 2000. The Department of Justice has agreed to collect this fee for DHS.

Requestor Type Category Definitions

Nonprofit Organization – An organization in which no part of the income is distributable to its members, directors or officers. Record check requests submitted to the Crime Information Bureau by nonprofit organizations must include a copy of their 501{c}{3} ruling from the Internal Revenue Service.

Governmental Agency – A federal, state, county or municipal governing body created by constitution, state, code, charter, ordinance, rule or order and any formally constituted subunit or agency thereof. This category includes public school districts.

Any Other Requestor – Includes the general public, and individual, agency or organization that does not meet the definition of governmental agency, nonprofit organization or a criminal justice agency involved in the administration of criminal justice.

Document Specifications

Fact Name Description
Form Title DJ-LE-250A, titled "Wisconsin Criminal History Multiple Name Record Request."
Governing Law The form is governed by Wisconsin Statutes 19.35(1) and 165.82.
Request Purpose Users must indicate the purpose of the request, such as general information or caregiver background checks.
Fees A fee of $12.00 applies for all request types, along with an additional $3 fee for certain caregiver requests.
Submission Requirements A self-addressed, postage-paid envelope must accompany each request.
Processing Time Requests generally take up to 10 business days to process, excluding mailing time.
Types of Requestors Eligible requestors include government agencies, nonprofit organizations, and the general public.
Information Required Requestors must provide the full name, sex, race, and date of birth of individuals being checked.

Steps to Filling Out Dj Le 250A

Filling out the DJ Le 250A form is essential for obtaining criminal background checks on multiple individuals. It is important to follow the steps carefully to ensure that all required information is accurately provided. This will help the processing of your request to proceed smoothly.

  1. Complete the "Return request to" section at the top of the form. Include the name, attention line, phone number, street address, city, state, and zip code.
  2. Select your requestor type by checking one of the provided boxes. If you represent a nonprofit organization, remember to include a copy of your 501(c)(3) approval from the IRS.
  3. Indicate the request purpose by checking the relevant box. If making a caregiver background check request, ensure to check that specific box and provide additional required numbers.
  4. Enter the total number of requests being made in the designated section on the form. Make sure to multiply the search fee per request to calculate the total amount required.
  5. Select the appropriate payment type by checking one of the provided boxes. If you are on an account that allows billing, include your account number; otherwise, attach a check or money order for the total amount.
  6. Fill in the required information for each individual: last name, first name, middle name, sex, race, and date of birth. Social security numbers can also be provided as an optional identifier but can help in avoiding mismatches.
  7. Attach a self-addressed, postage-paid envelope for your inquiry. Make sure the envelope has sufficient postage for return mail.
  8. Mail your completed form to the Crime Information Bureau using the address provided: Crime Information Bureau, Attn: Record Check Unit, PO Box 2688, Madison, WI 53701-2688.

After submitting the form, it may take up to 10 business days to receive the results. If there is no criminal record, the form will be returned stamped "No Record." If a record exists, it will be attached to your form and sent back to you.

More About Dj Le 250A

What is the purpose of the DJ-LE-250A form?

The DJ-LE-250A form is used to request criminal background checks for multiple individuals in the state of Wisconsin. It allows organizations and individuals to obtain public criminal history information held by the Crime Information Bureau.

Who can request a background check using this form?

Any person or entity may request a criminal background check for any subject. This includes government agencies, nonprofit organizations, public housing authorities, and members of the general public. However, only authorized individuals can access juvenile records, as this information is not publicly available unless specifically allowed by law.

What information do I need to provide on the form?

Complete information for each individual being checked is required, including last name, first name, middle name, sex, race, date of birth, and any other identifying data such as a Social Security number. You will also need to fill out the “Return request to” section and indicate your requestor type and request purpose. Without this information, your request may be delayed or processed as a general information request.

What is the cost for requesting background checks?

The fee for each background check is $12.00. If you are requesting caregiver background checks, an additional fee of $3.00 must be added. Payment can be made via check or money order, made out to the Wisconsin Department of Justice. If you are part of a governmental agency and have an account, you can provide your account number for billing.

How long will it take to receive the results of the background check?

Please allow up to 10 business days for processing. Additional mailing time may also be required based on postal service timelines. If there is no record on file, the completed form will be returned stamped “No Record.” If a record is found, it will be attached and sent back to you.

What should I include when submitting my request?

Be sure to include a self-addressed, postage-paid envelope with your request to ensure its return. Make sure you include sufficient postage as well. All the required information must be filled out completely, and payment must be included. Failure to provide any of this information could result in delays.

Common mistakes

  1. Missing Required Information: One of the most common mistakes when filling out the DJ-LE-250A form is failing to complete all required fields. Essential data such as the requestor type, purpose, and personal details of individuals being checked must be provided. Without this, the request may be returned or delayed.

  2. Incorrect Payment Method: Another frequent error involves the payment. Applicants sometimes choose the wrong payment type or fail to calculate the total amount correctly. Ensure that the appropriate fee, which can vary based on requestor type and additional charges, is included with the submission.

  3. Incomplete Identification Details: People often neglect to provide complete identifying information for each individual on the form. Missing or incorrect names, dates of birth, or sex can result in mismatches or failure to locate records accurately. Ensure that these details are typed clearly and accurately.

  4. Insufficient Postage: Individuals sometimes overlook the need for a self-addressed, postage-paid envelope. Not only must it be included, but it should also have sufficient postage to prevent delays in processing. Submitting the form without proper postage may lead to the request being returned or not sent at all.

  5. Ignoring Special Instructions: Lastly, some users fail to read and adhere to specific instructions regarding the purpose of the request or the type of checks being requested. Skipping these details can result in processing delays. Each box on the form should be carefully considered and checked based on the actual purpose.

Documents used along the form

The DJ-LE-250A form is commonly used to request multiple criminal background checks in Wisconsin. When utilizing this form, there are several other documents that may also be needed to provide additional context or fulfill specific requirements. Below is a list of these documents, along with brief descriptions to guide you through the process.

  • DJ-LE-250: This form is used for requesting a criminal background check on a single individual. It is ideal for those needing information about one person at a time.
  • 501(c)(3) Verification: Nonprofit organizations must include this document to confirm their status. It provides evidence that the organization is exempt from federal income tax.
  • Payment Submission: Include a check or money order for the required fee when submitting any request. This document ensures that the payment is processed smoothly.
  • Provider Licensing Document: If you are checking caregivers, a document showing their licensing or registration status may be needed, especially in childcare settings.
  • Self-Addressed Envelope: A postage-paid envelope is necessary for the return of your record check. This helps ensure prompt and secure delivery of results.
  • DHS Caregiver Check Request: If you are requesting caregiver background checks, this documented request must be included to comply with relevant laws and regulations.
  • Public Defender Information: Public defenders need to provide their SPD number when submitting requests to confirm their eligibility for fee exemptions.
  • Agency Number Documentation: Child day care providers need to submit details such as their facility number or certifying agency number for processing specific checks.
  • Authorized Personnel Notification: Organizations may provide a letter or email notification indicating which personnel are authorized to make background check requests on behalf of the organization.

These documents collectively facilitate the retrieval and processing of background check requests, ensuring compliance with state laws and effective management of information. It’s important to gather all necessary forms and documentation to avoid any delays in your inquiries.

Similar forms

The DJ-LE-250 form is quite similar to the National Crime Information Center (NCIC) report request form. Both forms are used to request information regarding an individual's criminal background, but the NCIC serves as a national database that provides criminal history information from multiple states. While the DJ-LE-250 focuses specifically on Wisconsin criminal records, the NCIC can provide insights into crimes that occurred elsewhere, making it particularly useful for anyone conducting thorough background checks across borders.

Another comparable document is the Federal Bureau of Investigation (FBI) Criminal Background Check Request form. This form allows individuals or organizations to request a comprehensive background check from the FBI database, which encompasses information from all 50 states. Much like the DJ-LE-250A, the FBI background check requires detailed personal information to verify the individual's identity. The FBI report may offer a more expansive view of a person's criminal history, especially for national security or employment purposes.

The form used to request a state-level background check in Michigan is also similar to the DJ-LE-250A. This Michigan State Police Criminal Background Check form serves a similar purpose, obtaining details on a person's prior crimes or arrests within the state. Just as the DJ-LE-250A is designed for multiple names, Michigan's version also accommodates multiple individuals and helps various agencies, employers, and organizations make informed decisions.

In New York, the Request for Criminal History Record Information (CHRI) form aligns closely with the DJ-LE-250A. This document allows requesters to obtain information pertaining to New York State criminal records. It includes necessary identification details similar to those in the Wisconsin form and aims to provide individuals with the pertinent background checks needed for employment, licensing, or other purposes.

The California Department of Justice also has a form for background checks that mirrors the DJ-LE-250A's intent. The Live Scan form facilitates the collection of digital fingerprints and allows the California DOJ to pull up criminal records on multiple individuals. Similar to what DJ-LE-250A achieves, California's process enables employers and agencies to ensure the safety and reliability of individuals they are considering for employment or assignments.

A comparable form is the Texas Crime Records Service request form, which is designed for obtaining background checks within Texas. Requesters can obtain criminal history records by submitting this form, similar to the process followed in Wisconsin. It captures necessary personal information and specifies the purpose of the request. This parallels the use of the DJ-LE-250A and demonstrates the importance of state-regulated background checks nationwide.

Lastly, the Criminal History Record Check form used in Florida is similar to the Wisconsin DJ-LE-250A. This request form allows individuals to gain access to their own or another person's criminal history record. While the Wisconsin form focuses on a specific state’s records, Florida’s version also allows inquiries aimed at safeguarding against potential risks. This shared purpose emphasizes the commitment of both states to improve safety through transparency in criminal history.

Dos and Don'ts

When filling out the DJ-LE-250A form, consider these important guidelines.

  • Do: Ensure you complete the "Return request to" section with accurate information.
  • Do: Include a self-addressed, postage-paid envelope with your submission.
  • Do: Check the appropriate boxes for your requestor type and purpose.
  • Do: Provide complete identifying information for each individual being checked.
  • Don't: Omit payment details. Always multiply the fee by the number of requests.
  • Don't: Leave required fields blank, such as name, date of birth, and requestor type.
  • Don't: Forget to include all necessary documentation, such as proof of nonprofit status if applicable.
  • Don't: Attempt to submit an additional envelope for caregiver results; they will be sent to the specified address.

Misconceptions

Below are some common misconceptions regarding the DJ-LE-250A form, along with clarifications to help demystify its purpose and usage.

  • Only government agencies can use this form. This is not true. While government agencies can certainly use the DJ-LE-250A form, it is also available for use by the general public, nonprofits, and other organizations.
  • A requestor does not need to specify the purpose of the background check. In actuality, you must check a box indicating the purpose of your request. Requests without a specified purpose are processed as general inquiries.
  • This form is only for checking one individual's background. The DJ-LE-250A is specifically designed for requesting background checks on multiple individuals. For a single individual, a different form (DJ-LE-250) should be used.
  • Payment is only required from nonprofit organizations. This is a misconception. All requestors, including individuals and government entities, are required to pay the established fee for background checks.
  • A self-addressed envelope is optional. Incorrect! A self-addressed, postage-paid envelope is mandatory for all inquiries. Without it, your request may not be processed.
  • Juvenile records are automatically provided. This is misleading. The form only facilitates access to adult criminal history data. Juvenile records are not released unless specifically authorized by law.
  • Your Social Security Number must be included on the form. While providing your Social Security Number is optional, doing so can help avoid mistakes by serving as a unique identifier.
  • The results of caregiver background checks are returned with the DJ-LE-250A form results. This is misleading. Caregiver background check results are returned separately from general criminal history results.

Key takeaways

The DJ-LE-250A form is vital for requesting criminal background checks in Wisconsin. Here are some key takeaways to keep in mind:

  • Be thorough. Fill out all required fields accurately, including names, dates of birth, and identifying information. Accurate details help ensure the effectiveness of your request.
  • Check the correct boxes. Indicate your requestor type and purpose clearly to avoid delays. Each category has specific guidelines, especially for nonprofit organizations and public defenders.
  • Enclose payment. Calculate the total amount based on the number of requests and applicable fees. This is necessary to process your request without delays.
  • Include a self-addressed envelope. Ensure you include a postage-paid envelope with your request. Insufficient postage will cause delays in returning your request.
  • Allow time for processing. Expect at least 10 business days for the background check. Be aware that additional mailing time may also apply.