Form 1-796 Rap Back Services Form

Rap Back Services Form

Name: _________________________
UCN/FBI#: ___________

SID#: _________

RB Sub ID: _____________
Requested Service:
Subscription Type:
RB Category:

(circle)

3) Firearms

(circle)
(circle)

DOB: ____________

EVI: ______________________

Subscribing CRI: ___________

Submitting ORI: ___________

1) Enroll 2) Replace 3) Renew 4) Cancel 5) Delete 6) Append 7) Un-Cancel

Civil

/

Criminal

1) Volunteer, Child Care/School Employee 2) Non-Criminal Justice Employment & Licensing

4) Criminal Justice Employment

6) Criminal Justice – Supervision

Expiration Date: ___________

2) Tier 2 (5 years)

3) Tier 3 (Lifetime)

Opt out of In-State Notifications:

Triggering Events:

Dispositions

Warrant Entry

Warrant Deletion
SOR Deletion

5) Criminal Justice – Investigative

7) Security Clearance Information Act

Subscription Term: (circle) 1) Tier 1 (2 years)

SOR Entry

SSN: _____________

Civil Retain Submission
Warrant Modification

SOR Modification

Opt Out

Expunge/Partial Expungement
Consolidation

Death Notice

Criminal Retain

Attention Field (max 100 characters):
_____________________________________________________________________________________
_____________________________________________________________________________________
User Defined Field (max 1000 characters):
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Miscellaneous Notes from Submitting Agency:
_____________________________________________________________________________________
_____________________________________________________________________________________

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Name – Individual enrolling for Rap Back Subscription
DOB – Date of Birth
SSN – Social Security Number
UCN/FBI# - Universal Control Number/FBI# of the individual (Replaces FBI#)
SID# - State Identification Number assigned by the State Identification Bureau
EVI – Event Identifier
NCN – NGI Control Number (Replaces ICN/ECN#)
RB Sub ID – Rap Back Subscription Identification Number
Subscribing CRI – Subscribing Agency Identification Number
Submitting ORI – Submitting Agency Identification Number
Originating Agency Case Number – (Criminal Subscriptions Only) – Used to indicated Case Number Associated with
Subscription.
Requested Service – Type of service requested for the Rap Back Subscription
a. Enroll – Places a Rap Back Subscription on an individual
b. Replace – Update the existing data fields in the Rap Back Subscription. (Name, DOB, Rap Back Activity
Notification Format, Rap Back Opt-Out In State Indicator, Rap Back Attention Indicator, Rap Back
Expiration Date, Rap Back Trigger, Rap Back Recipient, Rap Back Disclosure Indicator, and Rap Back User
Defined.
c. Renew – Used with a Tier 1 or Tier 2 Subscription to establish a new Rap Back Subscription term equal to
the original term. (must include the FBI Number/UCN, Rap Back Subscription Identifier, and Expiration
Date)
d. Cancel – Used to cancel the Rap Back Subscription (must include the FBI Number/UCN and the Rap Back
Subscription Identifier)
e. Delete – Remove subscription data from the Rap Back Subscription
f. Append – Add additional information to the Rap Back Subscription
g. Un-Cancel –Re-Activate the Rap Back Subscription within 60 days of the Subscription being canceled.
(must include FBI Number/UCN and Rap Back Subscription Identifier)
Subscription Type – Type of Rap Back Subscription
a. Civil
b. Criminal
Rap Back Category – Identifies the correct category of the subscription so that NGI will use the correct Purpose Code
when generating criminal history information (only used for Category Based Subscriptions)
a. F – Firearms
b. I – Volunteer, Child Care/School Employee, Non-Criminal Justice Employee and Licensing
c. J – Criminal Justice Employee
d. S – Security Clearance Information Act (SCIA)
e. CI – Criminal Justice Investigative
f. CS – Criminal Justice Supervision
Rap Back Disclosure Indicator (Criminal Subscriptions Only) – Used to indicate whether the Rap Back Subscription
should be visible on Rap Sheets generated to other criminal justice agencies.
Subscription Term – Term of the Rap Back Subscription during which time no additional fee will be charged
a. Tier 1 – 2 years
b. Tier 2 – 5 years
c. Tier 3 – Lifetime
Activity Notification Format – Notification response designated by Subscription owner
Expiration Date – Date Rap Back Subscription expires and needs to be re-validated within NGI
Opt out of In-State Notifications – Notification not necessary if notifying event originated within the subscribing state
Rap Back Trigger – Specify which events to receive a Rap Back notification
a. Criminal Retain Submission (Default) – Retained Criminal Ten Print Submission
b. Dispositions – A reported disposition transaction
c. Civil Retain Submission (Limited) – A Retained civil transaction is placed on the Identity History Summary
d. Expunge/Partial Expungement – Complete or partial expungement of arrest information
e. Want Addition – An entry is added to the NCIC Wanted Person File or Immigration Violator File
f. Want Deletion – An entry is deleted from the NCIC Wanted Person File or Immigration Violator File
g. Want Modification – A modification is made to an Identity History Summary
h. Sex Offender Registry Addition – A record is entered into the Sex Offender Registry
i. Sex Offender Registry Deletion – A record is deleted from the Sex Offender Registry
j. Sex Offender Registry Modification – A record is modified in the Sex Offender Registry
k. Death Notice – NGI has received a death notice associated with a subscribed Identity.
l. Consolidation (Default) – Response generated when two UCNs are consolidated into one Identity History.
Attention Field (max 50 Characters) – Contains Subscriber-designated individual or Section to whose attention any
inquiry or notification should be directed and a 24/7 contact number.
Recipient Field (max 19 characters) – Contains ORI number of Recipient Agency
User Defined Field – Free text fields to include Field Name (50 characters) and Field Text (100 Characters) for use by
agencies.