Local Background Check Request Form

The following is a request for a background check with the Montezuma Police Department. This is a local check only. This form must be completed in full to process your request.

There will be a $5.00 fee associated with this request.

Name *

Street Address *

City *

State *

Zip Code *

Date of Birth *

Phone Number *

Email Address *

I swear, or affirm that these documents are for my personal use and will not be used as part of a commercial enterprise.

Upload Copy of Drivers License *

File

How would you like to receive your requested information? *

Local Background Check Request Form

Local Background Check Request Form

Individual Information

Uploaded Files: