This is a two-step form.  First, complete the information below and then the system will generate a summary that you will need to sign electronically, accepting it after it is signed.  If it is done correctly, you will see a large “checkmark” on the screen.

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Criminal History Record

Correspondence Supervisor
Texas Department of Public Safety
Crime Records Division
P.O. Box 75999
Austin, TX 78761-5999

The Texas Local Government Code Chapter 411 authorizes a city to obtain criminal history records from the Department of Public Safety as it relates to a person who is an applicant for employment at the City.

My signature below authorizes the Department of Public Safety to provide the City of West University Place, criminal history information that may be required to arrive at an employment decision.  In connection therewith and in consideration of the undertacking of the City of West University Place to review this criminal history information and to consider me for hire, I herby indemnify, release and hold harmless the City of West University Place including, but not limited to its officers, agent and employees, in both their public and private capacities. from and against and and all damages, costs, expenses and attorney’s fees for all claims and suits, including but not limited to claims for death, personal injury, and property damage arising out of or connected with the request and/or retrieval of the criminal history records authorized herein.

Please note:  It is a crime to disseminate this record to any person not authorized to receive the record including the person who is the subject of this record.  The subject of this record must obtain this record directly from the Department of Public Safety.  Government Code 411.085.