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BACKGROUND CHECK FORM
(Part A)
Criminal Check
Harris County Juvenile Probation

Pursuant to Title 37, Part 11, Chapter 344 of the Texas Administrative Code, the Harris County Juvenile Probation Department (HCJPD)
performs fingerprint-based criminal history checks on service providers, interns, volunteers, and mentors. In addition, per HCJPD policy,
the department performs initial and annual criminal history checks through TCIC/NCIC. This form must be completed and signed by
the applicant prior to processing both initial and annual criminal history checks.

SUBMISSION INSTRUCTIONS
HCJPD background check forms contain two parts which are used to process checks in two separate databases. Both sections (Part A &
Part B) of this form must be completed in full (including duplicate information) and each section requires a signature and date .
Upon completing, please scan and save both pages of this form in the following format:
Last Name, First Name for Name of Organization (Example: Smith, B