Statutes, codes, and regulations
New Hampshire Administrative Code
Title Saf - Department of SafetySubtitle Saf-C - Commissioner, Department of SafetyChapter 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

N.H. Code Admin. R. Saf-C 5703.10

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Current through Register No. 14, April 4, 2024
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
(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.

N.H. Code Admin. R. Saf-C 5703.10

(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

Amended by Volume XXXVII Number 15, Filed April 13, 2017, Proposed by #12132, Effective 3/17/2017, Expires 3/17/2027.