LEIN Request 19086.pdf

This is a LEIN (Law Enforcement Information Network) Request Form issued by the Michigan Department of Corrections for vendor and contractor criminal history clearance. The form is required for individuals seeking approval to enter Michigan Department of Corrections facilities for project work or visitation purposes. The specific facility and project referenced is the Michigan Reformatory Steam System Repairs/Replacement (File #472/19086.DCS). The form requests vendor or contractor information including name, address, date of birth, sex, and race, along with a driver's license number or state-issued identification card number necessary to complete the criminal history check through the Michigan Law Enforcement Information Network.

The LEIN check authorization grants the Michigan Department of Corrections permission to conduct a criminal background investigation to determine facility access eligibility. Vendors and contractors must be cleared through this process before gaining entry to any MDOC facility. The form includes staff use sections for documenting the reason for the LEIN check, the staff member requesting it, the person conducting the check, and clearance status (yes/no). Individuals may obtain their own Michigan criminal history records through www.michigan.gov/ichat for a fee. The form is CAJ-1037 REV. 04/18 and serves as a prerequisite administrative requirement for all potential facility visitors and contractors working on MDOC projects.