LEIN Request 15262.pdf
PDF 25 KB Posted
- Solicitation number
- RFQ 171 180000000684 4
- Issued by
- Bay County, Michigan
About this file
This is a LEIN (Law Enforcement Information Network) Request form from the Michigan Department of Corrections (MDOC) used to conduct criminal history checks for vendors and contractors seeking access to MDOC facilities. The form is designated for the Lakeland Correctional Facility Facility Monitoring System project (File #472/15262.SMD) and requires completion by any individual or contractor before approval to visit or meet with persons confined in Michigan Department of Corrections facilities. The form requests standard identification information including driver's license number, state identification card number, social security number, date of birth, race, and sex to facilitate the criminal history background check through the LEIN database.
The criminal history check must be cleared before facility access is granted, with results indicating either approval or denial based on the LEIN check outcome. Individuals seeking copies of their Michigan criminal history records may obtain them through www.michigan.gov/ichat, though a fee applies for this service. The form includes designated staff sections for recording the reason for the LEIN check, the staff member requesting the check, the person conducting the check, and completion date with initials, ensuring proper documentation and tracking of all background verification activities related to vendor and contractor access to the facility.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Addendum 1 15262.pdf | ||
| Drawings 15262 Monitor.pdf | ||
| Addendum 3 15262.pdf | ||
| Specs 15262 Monitor.pdf | ||
| Addendum 2 15262.pdf | ||
| Advertisement 15262.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
MICHIGAN DEPARTMENT OF CORRECTIONS
VENDOR/CONTRACTOR LEIN REQUEST
CAJ-1037
REV. 03/15
Please provide the information requested below. This information will be used to complete a criminal history check in the Michigan Law Enforcement Information Network (LEIN).
Your Driver’s License Number or State Identification Card Number and your Social Security Number is needed to complete this LEIN. Also needed are your date-of-birth, race and sex. Potential entry into MDOC facilities require that this LEIN check be completed and cleared.
Profession Vendor Contractor
Last Name (Please Print) First Name Middle Name
Address
City State Zip Code
Date of Birth Sex Race
Please provide the number of at least two of the following three types of identification:
Driver’s License # State issued by
State ID # State issued by
Social Security #
I authorize the Michigan Department of Corrections to conduct a criminal history check, so that I may be approved to visit/meet with persons confined in a Michigan Department of Corrections facility.
Signature Date
Staff Use Only
Reason for LEIN Check
Staff requesting LEIN Check
LEIN Checked by
LEIN Clear Yes No, You may obtain a copy of your Michigan criminal history at www.michigan.gov/ichat. There is a fee for this service.
LEIN Check completed by Initials Date http://www.michigan.gov/ichat hallt2 Text Box Facility/Project Name: Lakeland Correctional Facility - Facility Monitoring System File # 472/15262.SMD
File details come from the government source that posted it. Updated .