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Form 0-12
AWARENESS STATEMENT
State and Federal laws as well as GCIC Council Rules control the dissemination and use of
criminal history record information (CHRI) in Georgia. Such information may not be
disseminated further by authorized recipients, except as may be required for employment,
licensing, or other applicable decisions within recipient agencies. All persons to whom a CHRI
must be disseminated are required to sign an Awareness Statement, which is to be maintained,
subject to GCIC audit, by the designated agency representative. Criminal penalties
(imprisonment and/or fines) may be imposed for unauthorized dissemination of CHRI
(O.C.G.A.§25-3-38.
Criminal history record files maintained by the FBI and GCIC, and CHRI disseminated by such
agencies are based on post arrest fingerprint cards and reports of final dispositions of charges. It
cannot be guaranteed that files contain records of all arrests and/or final dispositions of charges.
For this reason, a criminal record or no record report, which is disseminated, is only presumed to
be an accurate reflection of its files as of the dissemination date. File transactions which occur
after disseminations are made will not be reported to previous recipients of such records/reports,
unless specifically required. Other than for a knowing and malicious release, or use of false
information, neither GCIC, its employees, the recipient agency, nor the designated agency
representative, shall be liable for defamation, invasion of privacy, or any other claim, based upon
good faith action pursuant to O.C.G.A. §35-3-35
Documents containing CHRI disseminated by GCIC and the FBI are provided to designated
agency representatives under the provisions of the cited Georgia statute solely for use in making
employment, licensing or other applicable decisions. The documents must be secured in locked
cabinets by recipient agencies, under the control of designated agency representatives.
Designated agency representatives shall maintain a log with entries which reflect the names of
applicants for whom record checks have been requested, dates of requests, names of person(s)
within the agency to whom CHRI disseminations have been made, and notifications of applicants
when required by O.C.G.A. §32-3-34(b) and/or 35-3-35(b). Such notifications shall include the
contents of any record furnished by GCIC and shall include the effect the record had upon any
adverse decision by the agency. Failure to provide the required information is a misdemeanor.
When no longer needed, the documents containing CHRI are to be destroyed so as to preclude
access to them by unauthorized persons.
By my signature below, I acknowledge that I have read this Awareness Statement.
_______________________________________      /     /     
Signature/Job Title of Designated Representative Date
           
Agency Name Agency ID No. (ORI)
           
Address Telephone Number
FC_0-12 Awareness Statement (Revised 09/06) Page 1 of 1

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Fc 0 12 awareness statement

  • 1. Form 0-12 AWARENESS STATEMENT State and Federal laws as well as GCIC Council Rules control the dissemination and use of criminal history record information (CHRI) in Georgia. Such information may not be disseminated further by authorized recipients, except as may be required for employment, licensing, or other applicable decisions within recipient agencies. All persons to whom a CHRI must be disseminated are required to sign an Awareness Statement, which is to be maintained, subject to GCIC audit, by the designated agency representative. Criminal penalties (imprisonment and/or fines) may be imposed for unauthorized dissemination of CHRI (O.C.G.A.§25-3-38. Criminal history record files maintained by the FBI and GCIC, and CHRI disseminated by such agencies are based on post arrest fingerprint cards and reports of final dispositions of charges. It cannot be guaranteed that files contain records of all arrests and/or final dispositions of charges. For this reason, a criminal record or no record report, which is disseminated, is only presumed to be an accurate reflection of its files as of the dissemination date. File transactions which occur after disseminations are made will not be reported to previous recipients of such records/reports, unless specifically required. Other than for a knowing and malicious release, or use of false information, neither GCIC, its employees, the recipient agency, nor the designated agency representative, shall be liable for defamation, invasion of privacy, or any other claim, based upon good faith action pursuant to O.C.G.A. §35-3-35 Documents containing CHRI disseminated by GCIC and the FBI are provided to designated agency representatives under the provisions of the cited Georgia statute solely for use in making employment, licensing or other applicable decisions. The documents must be secured in locked cabinets by recipient agencies, under the control of designated agency representatives. Designated agency representatives shall maintain a log with entries which reflect the names of applicants for whom record checks have been requested, dates of requests, names of person(s) within the agency to whom CHRI disseminations have been made, and notifications of applicants when required by O.C.G.A. §32-3-34(b) and/or 35-3-35(b). Such notifications shall include the contents of any record furnished by GCIC and shall include the effect the record had upon any adverse decision by the agency. Failure to provide the required information is a misdemeanor. When no longer needed, the documents containing CHRI are to be destroyed so as to preclude access to them by unauthorized persons. By my signature below, I acknowledge that I have read this Awareness Statement. _______________________________________      /     /      Signature/Job Title of Designated Representative Date             Agency Name Agency ID No. (ORI)             Address Telephone Number FC_0-12 Awareness Statement (Revised 09/06) Page 1 of 1