Form I-12 Flash/Cancellation Notice

Flash/Cancellation Notice

OMB 1110-XXXX

I-12 (Rev. 04-13-16)

Date

Form may be submitted by one of the following:
Mail To: FBI/CJIS Division
Fax: (304) 625-9746
Clarksburg, WV 26306
(date)
FLASH*

Email: cjisflashes@LEO.GOV

(date)

(date)

(date)

Mandatory Release

Expires

SPT

Expires

Supervised Release

Expires

PTD

Expires

Probation

Expires

PTS

Expires

Parole

Expires

When requesting flash notice, give the following information:
Date and Place of Sentence:*

Disposition:*

Charge:*

Contributor of Fingerprints:

CANCEL (Reason)

SUPERVISION TRANSFER NOTICE:

FROM:

Name*

Aliases

TO:

Residence*

Numbers

Occupation

Arrest

Military

Race

Sex

Height

FBI UCN**

Alien

Weight

Eyes

Hair

Date of Birth*

Social Security

Place of Birth

Citizenship

Scars, marks, and tattoos

Agency Case or File Number

Please Furnish Identification Record
Agency *ORI#, and Address of Parties to be notified of Apprehension:

Agency, *ORI#, and Address of Contributor

*Indicates fields that must be completed or form will be returned without being processed. See reverse side for instructions.
**If known

The completion of this form is voluntary; however, necessary to adequately update the record when a subject
is being placed on parole, supervisory release, pretrial diversion, probation, bail/bond supervisions, etc. The above
listed information has been labeled "FLASH information" and noted as such in the remaining instructions.
CANCELLATION information should be furnished when you no longer desire information concerning the
subject for which you have previously requested a flash notice.
TRANSFER information should be furnished when the supervision of a subject has been transferred
from one agency to another.
Fingerprints for an offense must be in the Criminal Justice Information Services Division, Next Generation
Identification (NGI) System and the FBI Universal Control Number (UCN) furnished when requesting a FLASH
notice; however, if the FBI UCN is known but the flash offense is not on file, fingerprints for the flash offense must be
submitted with the I-12. If you desire to have a FLASH NOTICE posted and are not certain whether an FBI identification
record exists for the subject, query the Interstate Identification Index (III) via the National Crime Information Center (NCIC).
Enter all available descriptive data to retrieve any identification record(s) possibly identical to your subject. If a possibly
identical record is located, determine whether or not the record is identical with the subject. If identical, place the UCN on
the I-12 and submit. If no record is identical to the subject, obtain fingerprints and submit with the I-12.
This form is only used for the above stated purposes.
If you have questions concerning the use of an Originating Agency Identifier (ORI) number, contact your state NCIC
Control Terminal Officer or Federal Service Coordinator.
Paperwork Reduction Act Notice
This notice is given under the Paperwork Reduction Act of 1995. The Paperwork Reduction Act requires that the Federal Bureau of Investigation inform individuals and other
entities of the following when asking for information. The information on this form will assure identity history information is appropriately collected, retained, amended and
thus disseminated in a manner that ensures the accuracy of the record in an effort to protect individual privacy as required by 28 CFR 20.1. It will ensure the FBI receives all
of the necessary information needed to removed identity history data within the NGI, streamline the flow of information, and ensure more timely transactions. The FD-1115
will promote timely processing by CJIS staff, minimize delays, reduce rejections to the submitting agency, and provide for efficient updating of identity histories within the
NGI systems.
The estimate average burden associated with this collection is 8 minutes per respondent, depending on individual circumstances. Comments concerning the accuracy of this
burden estimate and suggestions for reducing this burden should be directed to Department Clearance Officer, United States Department of Justice, Justice Management
Division, Policy and Planning Staff, Washington, DC 20530.