OKLAHOMA DEPARTMENT OF CORRECTIONS REQUEST FOR RECORD

OKLAHOMA DEPARTMENT OF CORRECTIONS REQUEST FOR RECORD
PLEASE RESPOND TO:
Requesting Employee Name
Facility Name
Facility Mailing Address
THIS FORM MUST BE FILLED OUT IN ITS ENTIRETY
Last Name*
Middle Name
First Name*
Alias(es)/any other names by which subject is known*
Please indicate reason for request:

Volunteer
Address*

Address (street, rural route, box #)

Street Address Line 2

CityState

Zip Code
Date of Birth (mm/dd/yyy)*
GENDER*
RACE*
EYE COLOR*
HAIR COLOR*
HEIGHT*
WEIGHT*
DRIVERS LICENSE NO*
SOCIAL SECURITY NO*
FBI NO
OSBI NO.
I certify that the information applied for is necessary in the interest of the due administration of the laws and not for the purpose of assisting a private citizen or for personal use.
Signature*

Clear
ORI No.
Date*

MonthDayYear
Date
Should be Empty: