DNA Request Form

"*" indicates required fields

Agency Requestor Contact Information

Enter your agency and contact information. DFS will only respond to agency-issued e-mail addresses.
Name*
Agency E-mail address*
Agency Address*

DNA Information

I am requesting information regarding whether the following individual’s DNA profile is in Virginia’s DNA Data Bank pursuant to Virginia Code § 19.2-310.5.
Name of Individual*
MM slash DD slash YYYY

Signature

Please sign below to authorize the request and accept the terms.
By [signing] below, I hereby certify that (1) I am a sworn law enforcement officer, and (2) this information is being obtained in furtherance of an official investigation of a criminal offense that occurred within the jurisdiction of my law enforcement agency. I understand that, under Virginia Code § 19.2-310.6, any person who disseminates, receives, or otherwise uses or attempts to so use information in the Data Bank, knowing that such dissemination, receipt, or use is for a purpose other than as authorized by law, shall be guilty of a Class 1 misdemeanor.
This field is for validation purposes and should be left unchanged.