COVER LETTER

REVISED 10/5/05
COVER LETTER
Date:
Requestor Name:
________________________________
Requestor Address:
________________________________
________________________________
________________________________
Attention Record Request:
I, ________________________, am requesting a criminal history backgroundcheck for personal review pursuant to 28CFR§16.30-16.34. Please mail theresults of the check to the following address:
_________________________________
_________________________________
_________________________________

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