CORI Forms, Applications and Model Policies

Beginning Monday, March 12, 2012, the DCJIS will stop accepting CORI Certification applications.   This change is necessary in order to transition to the new iCORI system that will be implemented on May 4, 2012.  All current CORI certifications have been extended through May 4, 2012. If your organization has a current CORI Certification, you will not be required to apply for re-certification.

Any agency which is not certified as of March 12, 2012, will be required to submit publicly accessible CORI requests.  Please click here pdf format of Changes to CORI Certification for additional information

Summary of Levels of CORI Access with Requestor Types pdf format of Summary of Levels of CORI Access with Requestor Types

CORI Acknowledgment Form - Employment and Housing pdf format of CORI Acknowledgment Form- Employment and Housing

CORI Acknowledgment Form - Organizations Using a CRA pdf format of CORI Acknowledgment Form - Organizations Using a CRA

Affidavit of Indigency

CORI Fee Waiver Form pdf format of CORI Fee Waiver Form file size 1MB

Adult Criminal History Request Form pdf format of Adult Criminal Record Request Form file size 1MB

Juvenile Criminal History Request Form

On Behalf of Child Care Provider pdf format of On Behalf of Child Care Provider

On Behalf of Home Health Aide pdf format of On behalf of Home Health Aide

Advocate, Attorney, Designated Representative pdf format of Advocate, Attorney, Designated Representative Form file size 1MB

Open Access pdf format of Open Access Form file size 1MB

Sealing a Massachusetts Criminal Record

Improper Access and/or Dissemination Complaint Form pdf format of CORI Complaint Form

DCJIS Model CORI Policy pdf format of DCJIS Model CORI Policy

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This document is to assist individuals that believe his or her CORI report contains inaccuracies. Certified agencies should provide a copy of this document to any applicant that needs to seek corrections for their criminal offender record information report.

The following information is a guide on the steps to be taken in order to establish yourself as a victim of identity theft for CORI purposes.
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 Identity (ID) Theft Cover Letter, Affidavit, and Consent Form pdf format of identity_theft_application_forms.pdf

The following is the enrollment application that needs to be completed and submitted to the Criminal History Systems Board in order to establish yourself as a victim of identity theft for CORI purposes.
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