LEIN Request 24126.pdf

This document is a LEIN (Michigan Law Enforcement Information Network) Request Form CAJ-1037 issued by the Michigan Department of Corrections for the Richard A Handlon Correctional Facility PA System Emergency Siren Upgrade project (File #472/24126.SMD). The form is used to conduct criminal history checks for individuals seeking access to the secure perimeter or property of MDOC facilities. The form requires submission of personal identifying information including driver's license or state identification card number, date of birth, race, and sex, along with the requestor's full name and address. Requestors must indicate whether they are entering the secure perimeter as employment/HR personnel, a requesting contractor, visitor, contractor, volunteer, or other designated representative and must provide authorization for MDOC to conduct the criminal history check for work, visiting, or interaction with MDOC offenders.

The form includes a certification signature section where the applicant authorizes the Department to conduct the background check and, for MDOC HR/Employment purposes only, to review motor vehicle operator license records to determine eligibility to operate vehicles during Department business. Upon completion, MDOC personnel responsible for processing the LEIN request must sign and date the form and indicate whether the applicant was cleared to proceed. The form also contains an optional comment field and space to record the number of convictions for HR employment purposes. This form is a standard security and access control document required prior to any personnel entry into MDOC facilities for the Handlon facility's PA system emergency siren upgrade project.