DGLandH - J.19 USCP Request for Check of Criminal History-Form CP-491 (May 2025).pdf

This is a criminal history records check request form (CP-491) used by the United States Capitol Police. The form is completed in two parts: the applicant section (sections 1-18) and the authorized requestor section (sections 19-25), with final processing by the Badging and Credentialing Division (section 26-29).

The applicant must provide personal identifying information including name, address, employer, USCP position to be filled, alternative names used, telephone number, date of birth, birthplace, Social Security number, country or citizenship, gender identity, race, height, weight, eye color, and hair color. The applicant certifies that the provided information will be used for criminal history record checking by the Federal Bureau of Investigation and authorizes its use for security determinations. The applicant must acknowledge that falsification of information is subject to prosecution and penalties, and must certify the accuracy and completeness of all information provided. The applicant signs and dates the form in section 17. The authorized requestor (sections 19-25) completes their name, agency, position/title, telephone number, and date of request, then verifies the applicant's authorization to work in the United States and confirms compliance with the Immigration Reform and Control Act of 1986 and applicable Form I-9 requirements and Memorandum of Understanding with the Capitol Police. The form requires a valid non-expired government-issued photo identification to be brought in person to the Badging and Credentialing Division at 499 South Capitol Street, SW, Room 127, Washington, DC 20003.