1.1 - Surname: Elkins
1.2 - Forename: Dominic
1.3 - Gender: Male
1.4 - Contact Number:2258763
1.5 - Current Address: N/A
1.6 - Copy of ID:
(( - To obtain your ID, type /licenses in-game, then press F8. Collect the screenshot at My Documents/GTA San Andreas User Files/SAMP/screens and if possible, please crop it so only the license is visible. Upload it on a image-sharing site like Imgur and paste the image direct link between the tags above. )) Section II - Criminal Record Request Information 2.1 Reason of request (Select one)
 A company requires my record for the position I am applying for. Please print what company on part 2.3.
[X] I want to have a copy for my own personal reference.
 None of the above, state your reason on 2.2. 2.2 - If the third option was selected, please print why:
2.3 - Company/Organization requiring the record: Section III - Declaration
I, [Dominic Elkins], certify that all the information provided within this request is accurate to the best of my knowledge and I understand that withholding information or providing false information will result in my application being denied and discarded, and that it could possibly lead to legal action being pursued in regards to §221.000 Obstruction of Justice as defined within the San Andreas Penal Code.
I acknowledge that criminal record requests cannot be performed by a third-party unless that third-party is a certified employer that is legally authorized to request criminal record checks on applicants and current employees within their organization or business. All the information that I have provided in this document is of my own and I am not filling illegally for a third party.
The document enclosed contains the criminal record of DOMINIC ELKINS as of 15/09/2020. It enumerates a list of criminal charges and fines issued to the subject in the State of San Andreas, and may not include federal records.
This document shall be used exclusively for the purpose indicated below. It shall remain confidential between the subject and/or the concerned organization's human resources department and/or management team if the document is used for background check purposes. It may not be used for legal purposes unless it is indicated on the purpose of request. This document is valid for SEVEN (7) days from date of posting.
Purpose of Record:(To be filled by the handling trooper with a [✓] mark)
[✓] Personal Reference
 Background Check for an Organization | Concerned Organization: Company
 Legal Purposes
 Other: Reason
CRIMINAL RECORD OF DOMINIC ELKINS Information validated as of 15/09/2020
Outstanding / Previous Charges
Sun, Sep 13, 2020 8:45 PM | DUI | $1.00
Tue, Sep 15, 2020 6:33 PM | Bribery of a Public Official | $1.00
Tue, Sep 15, 2020 6:34 PM | Evading | $1.00
Tue, Sep 15, 2020 6:34 PM | Reckless Driving | $1.00
Fines and Misdemeanors
If you have any questions or concerns about the subject's criminal record, you may contact a member of our Supervisory Team by calling 911 and choose the non-emergency option.
Trooper First Class Jim Sheffield
San Andreas State Police Si vis pacem, para bellum