Download the CORI Request Form now, or complete the online form below. The Springfield Police Department has been certified by The Massachusetts Criminal History Systems Board for access to conviction and pending criminal case data. As an applicant/employee for the position of:Hawker PeddlerSecond-Hand DealerPawn Brokers LicenseJunk Dealer LicenseFortune Teller LicenseConsent(Required) I understand that a criminal record check will be conducted for convictions and pending criminal cases only. The information below is correct to the best of my knowledge.Name First Middle Last Maiden Name or Alias Date of Birth MM slash DD slash YYYY Place of Birth Social Security # State Driver's License Number Hair Color Eye Color Weight Height Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Requested By Email Δ Share this:FacebookX