PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
DSHS Form 17-264
for the current year.
DSHS Form 17-264 Dvr Background Check Reporting - Washington
What Is DSHS Form 17-264?
This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is DSHS Form 17-264?
A: DSHS Form 17-264 is a background check reporting form used in Washington.
Q: What is Dvr?
A: Dvr stands for Division of Vocational Rehabilitation.
Q: Who is required to fill out DSHS Form 17-264?
A: Individuals who are applying for services through Dvr in Washington may be required to fill out this form.
Q: What is the purpose of DSHS Form 17-264?
A: The purpose of this form is to collect information for the background check process, which is necessary for certain types of services provided by Dvr.
Q: What information is included in DSHS Form 17-264?
A: The form collects personal information such as name, date of birth, and social security number, as well as information regarding criminal history, employment, and educational background.
Form Details:
- Released on January 1, 2019;
- The latest edition provided by the Washington State Department of Social and Health Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of DSHS Form 17-264 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.
