NC DAC LEO Access Request

Access Request

Instructions: Only Criminal Justice personnel may apply.

Please complete all required information. If you omit any information your request will not be processed. All information will be verified and all access requests are traced to their originating system. Falsifying information is a criminal offense and any attempt to do so will result in a criminal investigation.

If you did not mean to request access this application please return to
NC DAC Criminal Offender Searches.

Email Address

First Name

Last Name

Title or Role

Badge Number (optional)

Department or Agency

Departmental Phone Number

Departmental Address

Address Line 2 (optional)

City

State (if in USA)

Zip Code (if in USA)

Country

Departmental Contact to Verify your Position

Contact Phone Number

Reason for Request

Enter Security Code (seen at left)

Attestation (must be confirmed)

I confirm that I am a Criminal Justice/Law Enforcement employee and that the information provided here is true and accurate. I also understand that I am responsible for the security of the information I receive and confirm that I will not share this information with anyone who is not authorized to receive it.