Request for a Copy of Application or Score Summary Sheet

A copy of your application or score summary sheet can go directly to the jurisdiction you choose upon receiving a $30 fee in the form of a certified check, cashier's check or money order. Otherwise, if you are requesting the application copy\score summary sheet be sent to your own address choice, then a Notarized Identity Verification form (PDF) must be submitted along with with the $30 fee in the form of a certified check, cashier's check or money order.

Please note, if you submitted your application prior to July 2009, it is no longer available for reproduction. A score summary sheet of our records documenting relevant facts from your application is provided instead. This sheet does NOT include application disclosures.

Reason for Request:




Application Type:
First Name:
Middle Name or Intial:
Last Name:
Maiden or Last Name At Time of Filing:
Last 4 of SSN:
D.O.B.:
Address Line 1:
Address Line 2:
City:
State: Zip:
Phone:
Email Address: