New Hampshire Code of Administrative Rules
Saf - Department of Safety
Subtitle Saf-C - Commissioner, Department of Safety
Chapter Saf-C 5700 - OPERATION OF THE CENTRAL REPOSITORY: CRIMINAL RECORDS
Part Saf-C 5703 - SECURITY OF CRIMINAL HISTORY RECORD INFORMATION
Section Saf-C 5703.10 - Procedure for Any Person or Any Public or Private Agency to Request and Receive a Copy of the Criminal Conviction Record of Another

Universal Citation: NH Admin Rules Saf-C 5703.10

Current through Register No. 40, October 3, 2024

(a) To obtain a criminal conviction record of another, the requestor shall present a completed criminal conviction record release authorization form to the central repository, as specified in Saf-C 5703.11, in person or by mail.

(b) The criminal conviction record release authorization form utilized shall be as follows:

Table 5700-1 Criminal History Record Information Release Authorization Forms

Form Number	Title	How to Obtain:
DSSP 256	Criminal History Record Information Request Form (eff. 7/15/16)	www.nh.gov/safety/nhsp Department of Safety Division of State Police - Criminal Records Unit (603) 223-3867 33 Hazen Drive Concord, NH 03305
DSSP 371	DHHS/DCYF Relative Criminal Check Only (eff. 7/15/16)	www.dhhs.nh.gov Divisions/Offices; Division for Children, Youth and Families - Foster Care and Adoption (603) 271-4440 129 Pleasant Street, Concord, NH 03301
DSSP 372	License Exempt Child Care Form NH RSA 170-E:3-a (eff. 10/1/16)	www.dhhs.nh.gov Divisions/Offices; Office of Operations Support - Child Care Licensing Unit (603) 271-9025 129 Pleasant Street, Concord, NH 03301
DSSP 373	Applicants to Practice Medicine NH RSA 329:11-a (eff. 10/1/16)	www.oplc.nh.gov Office of Professional Licensure and Certification - Division of Health Professionals (603) 271-4728, 121 South Fruit Street, Suite 301, Concord, NH 03301
DSSP 374	Applicants to Physician Assistants RSA 328-d:3-a (eff. 10/1/16)	www.oplc.nh.gov Office of Professional Licensure and Certification - Division of Health Professionals (603) 271-4728, 121 South Fruit Street, Suite 301, Concord, NH 03301
DSSP 375	BDS Area Agencies or Community Mental Health Centers (eff. 7/15/16)	www.dhhs.nh.gov Divisions/Offices; Division of Community Based Care Services - Bureau of Behavioral Health (603) 271-5007 105 Pleasant Street, Concord, NH 03301
DSSP 376	TANF Requests for Child Care Form NH RSA 170-E:7, II (eff. 7/15/16)	www.dhhs.nh.gov Divisions/Offices; Division of Family Assistance - Temporary Assistance for Needy Families (603) 271-9700 129 Pleasant Street, Concord, NH 03301
DSSP 377	New Applicant - Adoptive Parents Form NH RSA 170-B:18 (eff. 10/1/16)	www.dhhs.nh.gov Divisions/Offices; Division for Children, Youth and Families - Foster Care and Adoption (603) 271-4440 129 Pleasant Street, Concord, NH 03301
DSSP 378	Background Check Request of Alcohol and Other Drug Use Counselors NH RSA 330-C (eff. 10/1/16)	www.oplc.nh.gov Office of Professional Licensure and Certification - Division of Health Professionals (603) 271-6761, 121 South Fruit Street, Concord, NH 03301
DSSP 380	Driver Education Instructors NH RSA 263:44-b, II (eff. 10/1/16)	www.nh.gov/safety/dmv Department of Safety Division of Motor Vehicles - Driver Education (603) 227-4075 23 Hazen Drive Concord, NH 03305
DSSP 381	Child Day Care NH RSA 170-E:7, II - Child Care Institutions RSA 170-E:29-a:II (eff. 02/20/15)	www.dhhs.nh.gov Divisions/Offices; Office of Operations Support - Child Care Licensing Unit (603) 271-9025 129 Pleasant Street, Concord, NH 03301
DSSP 382	School Employee/Volunteer Criminal History Record Check RSA 189:13-a (eff. 10/1/16)	www.nh.gov/safety/nhsp Department of Safety Division of State Police - Criminal Records Unit (603) 223-3867 33 Hazen Drive Concord, NH 03305
DSSP 383	County Employee Criminal History Background Check NH RSA 28:10-c (eff. 10/1/16)	www.nh.gov/government/local Counties Select Specific County
DSSP 384	DCYF Personnel (eff. 7/15/16)	www.dhhs.nh.gov Divisions/Offices; Office of the Commissioner - Human Resources (603) 271-9344 129 Pleasant Street, Concord, NH 03301
DSSP 385	DHHS Area Agencies (eff. 7/15/16)	www.dhhs.nh.gov Divisions/Offices; Division of Community Based Care Services - Bureau of Developmental Services (603) 271-5133, 105 Pleasant Street, Concord, NH 03301
DSSP 386	Department of Safety Employees NH RSA 21-P:15-c (7/15/16)	www.nh.gov/government/state Department of Safety Division of Administration (603) 223-8000 33 Hazen Drive Concord, NH 03305
DSSP 387	Board of Nursing NH RSA 326-b:15 (eff. 10/1/16)	www.oplc.nh.gov Office of Professional Licensure and Certification - Division of Health Professionals (603) 271-2323, 121 South Fruit Street, Concord, NH 03301
DSSP 388	Renewal - Foster Parents Form NH RSA 170-E:29 (eff. 7/15/16)	www.dhhs.nh.gov Divisions/Offices; Division for Children, Youth and Families - Foster Care and Adoption (603) 271-4440 129 Pleasant Street, Concord, NH 03301
DSSP 389	New Applicant - Foster Parents Form NH RSA 170-E:29 (eff. 7/15/16)	www.dhhs.nh.gov Divisions/Offices; Division for Children, Youth and Families - Foster Care and Adoption (603) 271-4440 129 Pleasant Street, Concord, NH 03301
DSSP 390	Hawkers, Peddlers, and Vendors Background Checks RSA 31:102-a & b (eff. 10/1/16)	www.nh.gov/government/local Select Specific Municipality
DSSP 391	Municipal Employee/Volunteer Candidate Background Checks NH RSA 41:9-b (eff. 10/1/16)	www.nh.gov/government/local Select Specific Municipality
DSSP 392	Licensing of Game Operators NH RSA 287-D:12 (eff. 10/1/16)	www.racing.nh.gov (603)271-3391 14 Integra Drive, Concord, NH 03301
DSSP 393	Real Estate Appraisers Board NH RSA 310-B:6-a (eff. 10/1/16)	www.oplc.nh.gov Office of Professional Licensure and Certification - Division of Technical Professions (603) 271-2219, 121 South Fruit Street, Concord, NH 03301
DSSP 394	Serve America Act Employees or Volunteers (eff. 10/1/16)	Provided to Applicant by Specific Employer
DSSP 406	Renewal - Adoptive Parents Form NH RSA 170-E:29 (eff. 7/15/16)	www.dhhs.nh.gov Divisions/Offices; Division for Children, Youth and Families - Foster Care and Adoption (603) 271-4440 129 Pleasant Street, Concord, NH 03301
DSSP 407	Child Day Care RSA 170-E:7, II-Child Care Institutions RSA 170-E:29-a, II (eff. 7/15/16)	www.dhhs.nh.gov Divisions/Offices; Office of Operations Support - Child Care Licensing Unit (603) 271-9025 129 Pleasant Street, Concord, NH 03301
DSSP 408	Consumer Reporting Agency (eff. 7/15/16)	Provided to Applicant by Specific Employer
DSSP 409	DCYF Intern/Volunteer Criminal Check Only (eff. 7/15/16)	www.dhhs.nh.gov Divisions/Offices; Division for Children, Youth and Families - Foster Care and Adoption (603) 271-4440 129 Pleasant Street, Concord, NH 03301
DSSP 410	DHHS-DCYF Behavioral Health Provider (eff. 7/15/16)	www.dhhs.nh.gov Divisions/Offices; Division of Community Based Care Services - Bureau of Behavioral Health (603) 271-5007 105 Pleasant Street, Concord, NH 03301
DSSP 411	DHHS Bureau of Behavioral Health (eff. 7/15/16)	www.dhhs.nh.gov Divisions/Offices; Division of Community Based Care Services - Bureau of Behavioral Health (603) 271-5007 105 Pleasant Street, Concord, NH 03301
DSSP 412	Applicants for Initial Registration/Reinstatement as A Medical Technician RSA 328-I:7 (eff. 10/1/16)	www.oplc.nh.gov Office of Professional Licensure and Certification - Division of Health Professionals (603) 271-8389, 121 South Fruit Street, Concord, NH 03301
DSSP 413	PL 108-79 Federal Prison Rape Elimination Act (PREA) [Contractor] (eff. 7/15/16)	www.dhhs.nh.gov Divisions/Offices; Division for Children, Youth and Families - Foster Care and Adoption (603) 271-4440 129 Pleasant Street, Concord, NH 03301
DSSP 414	PL 108-79 Federal Prison Rape Elimination Act (PREA) [Staff] (eff. 7/15/16)	www.dhhs.nh.gov Divisions/Offices; Division for Children, Youth and Families - Foster Care and Adoption (603) 271-4440 129 Pleasant Street, Concord, NH 03301
DSSP 415	Therapeutic Cannabis Program RSA 126-X:4, 8 (eff. 10/1/16)	www.dhhs.nh.gov Divisions/Offices; Office of Operations Support - Therapeutic Cannabis Program (603) 271-9234 129 Pleasant Street, Concord, NH 03301
DSSP 416	DHHS/DCYF Transportation and Child In Home Care (eff. 7/15/16)	www.dhhs.nh.gov Divisions/Offices; Division for Children, Youth and Families - Child Development (603) 271-4242, 129 Pleasant Street, Concord, NH 03301
DSSP 417	New Hampshire Medicaid Program (eff. 10/1/16)	www.dhhs.nh.gov Divisions/Offices; Office of Improvement and Integrity - Program Integrity Unit (603) 271-4344 129 Pleasant Street, Concord, NH 03301
DSSP 419	NH Banking Department/Banking Division (eff. 10/1/16)	www.nh,gov/banking (603) 271-3561 53 Regional Drive, Suite 200, Concord, NH 03301
DSSP 420	Nursing Home Administrators NH RSA 151-A:6-a (eff. 10/1/16)	www.oplc.nh.gov Office of Professional Licensure and Certification - Division of Health Professionals (603) 271-4728, 121 South Fruit Street, Suite 301, Concord, NH 03301
DSSP 421	Emergency Medical and Trauma Services NH RSA 153-A:10-a (eff. 10/1/16)	www.nh.gov/safety/fstems/ems Department of Safety Division of Fire Standards and Training- Bureau of Emergency Medical Services (603) 223-4200 98 Smokey Bear Blvd Concord, NH 03301
DSSP 422	NH Department of Revenue Employee Candidate Background Checks RSA 21-J:3-a (eff. 10/1/16)	www.revenue.nh.gov (603) 230-5000 109 Pleasant Street, Concord, NH 03301
DSSP 424	New Hampshire Banking Department/Consumer Credit (eff. 10/1/16)	www.nh,gov/banking (603) 271-8675 53 Regional Drive, Suite 200, Concord, NH 03301
DSSP 425	Games of Chance Facility License NH RSA 287-D:8, VII (eff. 10/1/16)	www.racing.nh.gov (603)271-3391 14 Integra Drive, Concord, NH 03301
DSSP 426	NH Banking Department Employees RSA 383:7 (eff. 10/1/16)	www.nh,gov/banking (603) 271-3561 53 Regional Drive, Suite 200, Concord, NH 03301
DSSP 427	Foster/Adoptive Adult Household Member Form NH RSA 170-E:29 (eff. 7/15/16)	www.dhhs.nh.gov Divisions/Offices; Division for Children, Youth and Families - Foster Care and Adoption (603) 271-4440 129 Pleasant Street, Concord, NH 03301

(c) In addition to the criminal conviction record release authorization form, $25.00 shall be included for the record check.

(d) On receipt of a completed criminal conviction record release authorization form and $25.00, a copy of the requested criminal conviction record shall be given or sent to the requestor.

(See Revision Note at chapter heading for Saf-C 5700) #6704, eff 3-3-98; amd by #8173, eff 9-21-04; amd by #8591, INTERIM, eff 3-24-06, EXPIRES: 9-20-06; ss by #8651, eff 6-2-06; ss by #9329, eff 11-21-08

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