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This form is used by the North Andover Council on Aging to request criminal offender record information (CORI) for individuals who will provide services to elderly or disabled persons, ensuring compliance
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How to fill out cori request form

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How to fill out CORI Request Form

01
Obtain the CORI Request Form from the appropriate state agency or website.
02
Fill out your personal information in the designated fields, including your name, address, date of birth, and social security number.
03
Provide any required identification details as specified in the instructions.
04
Sign and date the form to certify the accuracy of the information provided.
05
Submit the completed form along with any required fees to the appropriate agency as instructed.

Who needs CORI Request Form?

01
Individuals applying for jobs that require background checks.
02
Employers conducting background checks on potential employees.
03
Organizations that work with vulnerable populations, such as children or the elderly.
04
Individuals seeking to access their own criminal record information.
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How long will it take for me to get my CORI? Processing can take up to 10 business days, however, most CORI requests are processed in a shorter amount of time.
You must sign the CORI Acknowledgement Form in the presence of a Notary Public (or designated DPH employee), and verify your identity using a form of government-issued photo identification. Notaries are commonly found at banks.
A CORI form must be accompanied by a copy of one of the following: Driver's License. Passport. Alien Registration Card. Employment Authorization Card. US Military Identification Card.
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.
Fees NameFeeUnit Personal CORI request $25 per request Open access CORI request $50 per request Affidavit of indigency $0 per request
A Justice of the Peace who is designated to solemnize marriages or a justice who is a city or town clerk or court clerk or their assistant may charge a maximum fee of one hundred ($100) dollars to solemnize a marriage within their home community, or a maximum of one hundred and fifty ($150) dollars if the ceremony is

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The CORI Request Form is a document used to request a Criminal Offender Record Information (CORI) report, which includes an individual's criminal history in Massachusetts.
Individuals or organizations that wish to access someone's criminal history, such as employers, volunteer organizations, and licensing agencies, are required to file a CORI Request Form.
To fill out the CORI Request Form, individuals must provide their personal information, the type of check being requested, and any necessary identification details. It is important to accurately complete all required fields and to sign the form.
The purpose of the CORI Request Form is to facilitate background checks for employment, licensing, or volunteer opportunities by obtaining an individual's criminal history from the state.
The CORI Request Form must report personal identifying information such as name, date of birth, address, and Social Security number, along with the reason for the check and the consent of the individual being checked.
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