NCIC_CONSENT_FORM_INSTRUCTIONS.DOCX

NCIC CONSENT FORM (Required only for visitors who do not have a CAC or other Federal Government ID Card) All information MUST be legible on this form. If it cannot be read, it will not get processed.

The revised NCIC Consent Form offers the ability for visitors to be vetted for up to four years of access. Vetting will occur annually for the years that are checked on the NCIC Consent Form.

*** Common mistakes

*** I (print full name; first, middle, last): PRINT the visitor's full name; First, Middle, Last ---- It must be in that order.

I give consent to the VCC conducting my criminal history check:

One year only: Vetting will be conducted initially for access (additional vetting MAY occur within the first year). Based on the vetting results, the visitor will be granted UP TO ONE year access (based on MOTCO 190-3-R1 MAY 2019). *** NCIC Consent form and vetting results will be shredded after one year***

I give consent to the VCC conducting my criminal history check for an additional:

“1” year: Vetting will be conducted initially for access, and will automatically be conducted after one year. Based on the vetting results, the visitor will be granted UP TO TWO years of access (190-3 must reflect this). *** NCIC Consent form and vetting results will be shredded after TWO years***

I give consent to the VCC conducting my criminal history check for an additional:

“2” years: Vetting will be conducted initially for access, and will automatically be conducted after two years. Based on the vetting results, the visitor will be granted UP TO THREE years of access (190-3 must reflect this). *** NCIC Consent form and vetting results will be shredded after THREE years***

I give consent to the VCC conducting my criminal history check for an additional:

“3” years: Vetting will be conducted initially for access, and will automatically be conducted after three years. Based on the vetting results, the visitor will be granted UP TO FOUR years of access (190-3 must reflect this). *** NCIC Consent form and vetting results will be shredded after FOUR years***

Here are a couple examples:

1) You have a contractor that will be working on a project for 18 months, and they wish to opt into recurring vetting.

a. The MOTCO 190-3-R1 will have access from whenever they will need access through 18 months (1-Jun-19 thru 30-Nov-20)

b. The requestor will check mark the “Annual for ADDITIONAL “1” years” on the NCIC CONSENT FORM - May 2019 Fillable

2) You have a contractor that will be working on a project for 25 months, and they wish to opt into recurring vetting.

a. The MOTCO 190-3-R1 will have access from whenever they will need access through 25 months (1-Jun-19 thru 30-Jun-21)

b. The requestor will check mark the “Annual for ADDITIONAL “2” years” on the NCIC CONSENT FORM - May 2019 Fillable

3) You have a contractor that will be working on a project for 25 months, and they do NOT wish to opt into recurring vetting.

a. The MOTCO 190-3-R1 will have access from whenever they will need access through 12 months (1-Jun-19 thru 31-May-20)

b. The requestor will check mark the “One year only” on the NCIC CONSENT FORM - May 2019 Fillable

c. At the expiration of the vetting year, a new 190-3 and NCIC Consent Form will be required for further access.

***** OPTING OUT OF RECURRING VETTING MUST BE DONE IN WRITING THROUGH MOTCO SPONSOR *****

***** IT IS STRICTLY UP TO THE REQUESTOR IF THEY WISH TO OPT INTO RECURRING VETTING *****

Signature of Requestor: This is where the individual requesting access signs.

Race: Enter the visitor's race American Indian, Asian Indian, Black, Cambodian, Chinese, Filipino, Guamanian, Hawaiian, Hispanic/Mexican/Latin, Korean, Laotian, Other, Other Asian, Pacific Islander, Samoan, Vietnamese, White ***Human is not an acceptable answer and will be returned to sponsor to have fixed***

Date: Enter the date the form is being signed.

Date of Birth: Enter the visitor's date of birth.

*** Place of Birth (City and State): Enter the city and state of the visitor's place of birth. This is very important and the main reasons forms are returned for correction. If the place of birth is outside the United States it also must contain a city. For example: Tijuana, Mexico

Gender: Enter the visitor's gender.

Social Security Number: Enter the visitor's Social Security Number.

DL#/State: Enter the Visitor’s driver’s license number and state.

Address: Enter the visitor's CURRENT PHYSICAL address.

Company Name: Enter the visitor's company name.

Telephone: Enter the visitor's contact information.

It is recommended you type the information on the NCIC and then have the visitor sign the document.

If you send a NCIC form that is not properly filled out, changes cannot and will not be made to it. The NCIC Consent Form is authorization to perform a criminal background check utilizing the Federal Bureau of Investigation (FBI) criminal database. Sponsors are not authorized to make alterations to a signed document. They will be held legally liable for the information it contains and the results.

Remember the sponsor is required to review and proofread the request PRIOR to sending it. Errors cause delay. Best practice: Send it right the first time.