DD Form 369 Police Record Check

What Is DD Form 369?

DD Form 369 also known as the Police Record Check is a document used for checking if the potential candidate wishing to enlist in the Armed Forces might have been previously involved with the police or other law enforcement agencies.

The Department of Defense-issued form – often incorrectly referred to as DA Form 369 – was last revised in December 2014 with all previous editions being obsolete. An up-to-date fillable version of the DD 369 is available for digital filing or download below.

This form facilitates background record reviews that are used to determine if the candidate is eligible to be accepted into the United States Army. All information provided on the DD Form 369 is checked by recruiting officials and official military personnel SORNs. The DD 369 may also be used by recruiting agencies for the purpose of conducting local police file reviews.

What Is On DD Form 369?

DD Form 369 is used to obtain all criminal record information from law enforcement agencies about a prospective enlistee in the Armed Forces of the United States. This information is considered confidential and will only be disclosed for recruiting purposes.

The form includes general information including the name and sex of the individual whose police record is being checked along with the name, rank, and title of the person making the request. DD 369 Forms are for use with police only and are not to be used for court record checks.

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1. DATE OF REQUEST
OMB No. 0704-0007
POLICE RECORD CHECK
(YYYYMMDD)
OMB approval expires
Dec 31, 2017
The public reporting burden for this collection of information is estimated to average 27 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing the burden, to the Department of Defense, Washington Headquarters Services, Executive Services Directorate, Directives Division, 4800 Mark Center Drive,
Alexandria, VA 22350-3100 (0704-0007). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection
of information if it does not display a currently valid OMB control number.
PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ORGANIZATION. RETURN COMPLETED FORM TO ADDRESS SHOWN AT BOTTOM OF FORM.
SECTION I - (To be completed by Recruiting Service)
2. NAME OF APPLICANT
3. SEX
4. PLACE OF BIRTH
(Last, First, Middle Name(s), Alias)
a. CITY
b. COUNTY
c. STATE
MALE
FEMALE
5. DATE OF BIRTH
7. SOCIAL SECURITY
b. RACIAL CATEGORY
6.a. ETHNIC CATEGORY
(X one or more)
NUMBER
(YYYYMMDD)
(1) AMERICAN INDIAN/ALASKA NATIVE
(4) NATIVE HAWAIIAN OR
(1) HISPANIC OR LATINO
OTHER PACIFIC ISLANDER
(2) ASIAN
(5) WHITE
(2) NOT HISPANIC OR LATINO
(3) BLACK OR AFRICAN AMERICAN
8. ADDRESS IN ADDRESSEE'S JURISDICTION
9. DATES RESIDED AT THIS ADDRESS
(See "MAIL TO" block)
a. FROM
b. TO
a. NUMBER AND STREET (Include apartment no.)
b. CITY
c. STATE
d. ZIP CODE
(YYYYMMDD)
(YYYYMMDD)
10. PERSON MAKING THIS REQUEST
a. NAME (Last, First, Middle Name(s))
b. RANK
c. SIGNATURE
d. TITLE
SECTION II - (To be completed by Applicant)
PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. Sections 136, 504, 505, 12102; 14 U.S.C. Sections 351 and 632; DoDI 1304.2; DoDI 1304.26; AR 601-270; OPNAVINST
1100.4C Ch-1; AFI 36-2003_IP; MCO 1100.75E; COMDTINST M 1100.2E; AR 601-210; and E.O. 9397, as amended (SSN).
PRINCIPAL PURPOSE(S): The information collected on this form is used to screen and identify applicants to the Armed Forces who may have
discreditable involvement with the police or other law enforcement agencies. Completed forms are used to conduct background records checks used
to determine eligibility of applicants for accession into the Armed Forces. Completed forms are covered by recruiting and official military personnel
SORNs maintained by each of the Services.
ROUTINE USE(S): DoD "Blanket Routine Use" 2, Disclosure When Requesting Information Routine Use, specifically applies: A record from a system
of records maintained by a DoD Component may be disclosed as a routine use to a Federal, State, or local agency maintaining civil, criminal, or other
relevant enforcement information or other pertinent information, such as current licenses, if necessary to obtain information relevant to a DoD
Component decision concerning the hiring or retention of an employee, the issuance of a security clearance, the letting of a contract, or the issuance
of a license, grant, or other benefit. The DoD Blanket Routine Uses at https://dpclo.defense.gov/Privacy/SORNsIndex/BlanketRoutineUses.aspx apply.
DISCLOSURE: Voluntary. However, failure of the applicant to complete Section II may result in refusal of enlistment in the Armed Forces of the
United States. An applicant's SSN is used to conduct the police records check and keep all records together during the enlistment process.
The data are for OFFICIAL USE ONLY and will be maintained and used in strict confidence in accordance with Federal law and regulations. Making a
knowing and willful false statement on this DD Form 369 may be punishable by fine or imprisonment or both. All information provided by you, which
possibly may reflect adversely on your past conduct and performance, may have an adverse impact on you in your military career in situations such as
consideration for special assignment, security clearances, court martial and administrative proceedings, etc.
SIGNATURE
11. I HEREBY CONSENT TO RELEASE FROM YOUR FILES
THE INFORMATION REQUESTED BELOW.
SECTION III - (To be completed by Police or Juvenile Agency)
The person described above, who claims to have resided at the address shown above, has applied for enlistment in the Armed Forces of the United
States. Please furnish from your files the information relative to Section III below. A return envelope is provided for your convenience.
12. DOES THE APPLICANT HAVE A POLICE OR JUVENILE RECORD, TO INCLUDE MINOR TRAFFIC VIOLATIONS?
YES
NO
(If YES, what was the offense or charge, date, disposition and sentence?)
13. IS APPLICANT NOW UNDERGOING COURT ACTION OF ANY KIND?
YES
NO
(If YES, give details.)
THIS IS TO CERTIFY THAT THE ABOVE DATA, AS CORRECTED, ARE TRUE AND CORRECT ACCORDING TO THE RECORD ON FILE IN THIS
OFFICE. THIS INFORMATION IS CONFIDENTIAL AND CANNOT BE USED IN ANY OTHER MANNER EXCEPT FOR OFFICIAL PURPOSES.
14. DATE
15. TITLE
16. VERIFIED BY
(YYYYMMDD)
(Signature)
LAW ENFORCEMENT AGENCY
RECRUITING AGENCY
MAIL TO:
MAIL FROM:
DD FORM 369, DEC 2014
PREVIOUS EDITION IS OBSOLETE.
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How to Fill Out Form DD 369?

DD Form 369 must include the name that the applicant provides during enlistment along with the name on their birth certificate and maiden name, and any other name the applicant is also known as. All known names must be listed on the form prior to it being completed by the servicing agencies. The other lines on the DD 369 are self-explanatory and include the date and place of birth, social security number, ethnicity, a privacy act statement and a consent for release of information.

The record check must be signed by the applicant.

All copies of the DD Form 369 from civilian agencies must have fully completed Items 12 through 16 in Section III. Police checks are also possible through telephone calls. The person obtaining telephonic police records check will sign a written report on the DD Form 369 in Items 14 through 16 and identify the person they called  in Item 13.

Forwarding the completed form to the FBI or any foreign agencies is prohibited.

Police records check from law enforcement agencies that charge a fee to disclose information are not required. If a city or county does not have their own police force or is covered by another agency, Item 12 of the DD Form 369 must provide information explaining which agency has jurisdiction over that area.

How Long Is a DD Form 369 Good For?

Unless no new law violations occur, the DD Form 369 is valid indefinitely. The form is valid for six months when processing waiver applications.

For waivers, DD Form 369 will be reprocessed if older than 180 days. New records checks must be obtained if an applicant alleges to new arrests or convictions.