LEIN Request.pdf

This is a LEIN (Law Enforcement Information Network) Request form issued by the Michigan Department of Corrections (MDOC) requiring criminal history verification for vendors and contractors seeking access to MDOC facilities. The form mandates completion of background checks for all individuals who need to visit or meet with persons confined in Michigan Department of Corrections facilities. Required information includes the applicant's full name, address, date of birth, sex, race, and at least two forms of identification from the following: driver's license number, state-issued identification card number, or Social Security number. The applicant must provide written authorization for MDOC to conduct the criminal history check through the LEIN system. Upon completion, the form indicates whether the applicant has cleared the LEIN check, with a "Yes" or "No" determination required before facility access is granted.

The form includes staff-only sections for tracking purposes, including fields for the requesting staff member, the individual conducting the LEIN check, completion date, facility or project name, and file number. Applicants denied clearance may obtain a copy of their Michigan criminal history through the state's official ICHAT website at www.michigan.gov/ichat, though a fee is associated with this service. This LEIN Request form (CAJ-1037, Rev. 03/15) serves as a prerequisite administrative document rather than a solicitation for goods or services, functioning as a mandatory screening requirement for vendor and contractor access to MDOC operations.