Form Center

2. Record Check for Local Arrest Record
   
   Dubuque Law Enforcement Center
   
   855 Central Avenue, Dubuque, IA 52001
   
   Phone: 563-589-4443 Fax: 563-587-3849
4. 
   
6. Name of Applicant*
8. Maiden Name of Applicant or Other Name(s) Used by Applicant
10. Social Security Number
12. Date of Birth*
14. Previous Address(es) of Applicant
16. Name of Person Making Request*
18. Company
20. Address*
22. E-mail Address
24. Phone*
26. Fax
28. Date of Request*
30. Preferred Method of Receiving Results of Criminal Background Check*
    -- Select One --FaxMailPick-up (in person)
32. Print the form and mail, fax or drop off at the Dubuque Police Department. See information above. Select the "Print Only" button below, and when the next screen appears, choose "File - Print" at the top of your screen to print the form. After successfully printing your document, click "Continue" to be redirected to the City's website.
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33. Print Only

* indicates a required field