Background Check Waiver

You may complete and submit this waiver prior to reporting to the Police Services Center, no more than 5 days in advance of your scheduled appointment. Please schedule your appointment prior to completing this waiver.

Acknowledgement and Waiver

I certify that the personal identifiers provided on this form are accurate and I voluntarily and knowingly authorize the Ohio Bureau of Criminal Investigation and/or the Federal Bureau of Investigation to conduct a criminal records check for the information relating to me. I also voluntarily and knowingly authorize BCI to disseminate criminal conviction and juvenile delinquency adjudication records to the above listed address. I voluntarily and knowingly release and discharge the Ohio Attorney General’s Office, BCI, the FBI, Miami University, and their employees from all claims and liability related to this authorized criminal record review and dissemination.

Acknowledgement and Waiver

I agree

Type of Background Check and Payment Information

Date of Scheduled Appointment

Type of Background Check

Ohio $38.00

FBI only $40.00

Ohio/FBI $63.00

Black Ink Card $14.00 plus $1.00 for each additional card

Payment Type

Check Credit Card Charge to University Department Invoice Bursar

Credit Card and Check Payments

Link to payment portal is on Google Booking Appointment Page, or can be found at https://miamioh.nbsstore.net/fingerprinting-fee

MU Index & Account Number to Charge

Invoice Customers

Banner ID Number Required for Bursar Charge

Bursar Charge

I give permission for the MUPD to charge my bursar account for the civilian background check fee.

Distribution of Results (There are two ways to distribute results)

This is the first way to distribute results. If you do not need to send to one of the boards listed, please select "NONE". For additional guidance on what to select, call 513-529-2226. Typically used for state certification, additional options on result distribution below

Direct Copy to (select only one)

Second way to distribute results. For guidance on what to select, call 513-529-2226.

How results should be handled? Select one of the options.

I wish to mail my results to an address (once selected additional options will appear)

I wish to pick up my results (once results are available, MUPD will contact you)

I do not wish to pick up results, only need sent to Direct Copy

N/A - Black ink card(s) returned to customer to mail/submit)

Mail my results to the following

Please provide the address:

Personal Information

Reason for Background Check or ORC Codes provided by employer (Reason Codes)

Have you lived in Ohio for the last 5 years (consecutively without interruption)?

Yes No

Is the applicant 18 years of age, or older at the time of the scheduled appointment?

Yes No

Date of Birth

Parent/Guardian Information - Please provide first/last name, phone number, and email address:

Permanent Home Address

Your Phone Number

Last four SSN

If married, Maiden Name

Your name

Your email address

Your phone number

Verification Code

Background Check Waiver

Acknowledgement and Waiver

Type of Background Check and Payment Information

Distribution of Results (There are two ways to distribute results)

Personal Information

Other Fields