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This document is used by organizations to conduct criminal offender record information (CORI) checks for various purposes including employment, volunteer work, subcontracting, licensing, and housing.
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How to fill out criminal offender record information

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How to fill out Criminal Offender Record Information (CORI) Acknowledgement Form

01
Obtain the Criminal Offender Record Information (CORI) Acknowledgement Form from the appropriate agency or website.
02
Carefully read the instructions provided on the form.
03
Fill in your personal information, including your full name, address, date of birth, and any identification numbers required.
04
Check the box indicating your authorization for a background check.
05
Sign and date the form to confirm your understanding and consent.
06
Submit the completed form to the designated agency or employer as instructed.

Who needs Criminal Offender Record Information (CORI) Acknowledgement Form?

01
Individuals applying for jobs that require a background check.
02
Volunteers in organizations working with vulnerable populations.
03
Certain license applicants or professionals in regulated industries.
04
Persons involved in legal proceedings where a background check is necessary.
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Download and print out the Personal CORI Request Form from the Department of Criminal Justice Information Services (DCJIS) website. Or call DCJIS at 617-660-4600 (for TTY, call 617-660-4606) to get the form by mail. It is important to write neatly. DCJIS may send back forms that are hard to read.
Most criminal background checks go back at least seven years. Federal laws place no limit on the lookback period for criminal convictions, but some state laws impose restrictions. The federal lookback limit for other types of criminal records, such as arrests that didn't lead to a conviction, is generally seven years.
The CORI report you get lists all your cases. Your report includes cases that were dismissed or cases where you were found not guilty. The CORI report many employers get lists your open cases and cases that ended in a conviction. Convictions are cases where you were found guilty.
Some people have the misconception that their criminal record will “clear” after a period of 7 years. This is a misnomer. Although your criminal record does not automatically clear after 7 years, you can take steps to have your case expunged or your record sealed.
A pre-employment background check in Massachusetts may show a wide range of information, including a candidate's criminal history, motor vehicle records, employment and education information, and civil court records. In addition, employer drug screenings can show current and prior drug use.
Fees NameFeeUnit Personal CORI request $25 per request Open access CORI request $50 per request Affidavit of indigency $0 per request

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The Criminal Offender Record Information (CORI) Acknowledgement Form is a document that individuals must complete when they are subject to a background check regarding their criminal history. It serves to inform them about how their criminal record may be used.
Individuals applying for certain positions, especially in fields such as education, healthcare, and any role involving work with vulnerable populations, are typically required to file the CORI Acknowledgement Form.
To fill out the CORI Acknowledgement Form, you typically need to provide personal information such as your name, date of birth, social security number, and address. It's crucial to read the instructions carefully and sign the form where indicated.
The purpose of the CORI Acknowledgement Form is to ensure that individuals are notified about the use of their criminal records for employment or volunteer screening, and to give them an opportunity to verify the accuracy of the information.
The information that must be reported on the CORI Acknowledgement Form typically includes personal identification data, such as full name, date of birth, address, and any previous names or aliases used.
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