A. Personal Information
B.Reason for the Criminal Record Verification
C. Informed Consent
SEARCH AUTHORIZATION – I HEREBY CONSENT TO THE SEARCH OF the RCMP National Repository of Criminal Records based on the name(s), date of birth and where used,
the declared criminal record history provided by myself. I understand that this verification of the National Repository of Criminal Records is not being confirmed by
fingerprint comparison which is the only true means by which to confirm if a criminal record exists in the National Repository of Criminal Records.
AUTHORIZATION AND WAIVER to provide a confirmation of criminal record or any police information.
(City and Country)
I hereby release and forever discharge all members and employees of the processing Police Service and the Royal Canadian Mounted Police from any and all actions, claims
and demands for damages, loss or injury howsoever arising which may hereafter be sustained by myself as a result of the disclosure of information by the
D. Identification Verification
Declaration of Criminal Record
Information is collected and disclosed in accordance with federal, provincial and municipal laws.
A Declaration of Criminal Record does not constitute a Certified Criminal Record by the RCMP and may not contain all criminal
Applicants must declare all convictions for offences under Canadian federal law.
Do not declare the following:
- A conviction for which you have received a Record Suspension (formerly pardon) in accordance with the Criminal Records Act;
- A conviction where you were a “young person” under the Youth Criminal Justice Act;
- An Absolute or Conditional Discharge, pursuant to section 730 of the Criminal Code;
- An offence for which you were not convicted;
- Any provincial or municipal offence, and;
- Any charges dealt with outside of Canada.
Note that a Certified Criminal Record can only be issued based on the submission of fingerprints to the RCMP National
Repository of Criminal Records.