Haverhill, MA - Public Record Request

Public Record Request Form

Criminal History Systems Board
200 Arlington Street, Suite 2200
Chelsea, MA 02150

Pursuant to Massachusetts General Laws, Chapter 6, Section 172, I understand that in order for a person's record of convictions to be publicly accessible, the person must have been convicted of a crime punishable by a term of five years incarceration; or convicted of a crime and sentenced to a term of incarceration, and currently, that is at the time of the request, incarcerated, on parole or on probation, or having completed all custody. The persons record will be open for one additional year if the crime was a misdemeanor, two additional years if the crime was a felony, or if the person was denied parole or returned as a parole violator, open for three years after the termination of all custody.

I also understand that the $25.00 fee required by the law for the record search is non-refundable if there is no record that is publicly available.

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Requestor's signature

Individual whose record you are seeking:

___________________	___________________	___
Last Name	First Name	MI
___________________
Maiden Name
___________________	___________________
Date of Birth (mm/dd/yy)	Social Security Number (requested but not required)