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  Chippewa Area Keryx
All LEIN clearance forms can be submitted here. You can download the LEIN form to your computer, fill it out, upload it and submit your forms right on this page.

Things to remember when completing a LEIN Form:
1) Please be sure to sign the form on both pages.
2) Indicate the facility you are planning on participating at on the top right corner in blank for "Corrections Agency". You can use the 3 letter abbreviations below:
URF=Chippewa Correctional Facility (East or West)
NCF=Newberry Correctional Facility
LMF=Alger Correctional Facility

3) Don't leave anything blank. Fill in non-applicable blanks with "N/A"

Please note that this form does not put you on the serenade or Ultreya list. Please send your request to participate in the serenade or Ultreya on the Ultreya/Serenade page. Generally, you must submit your name to these lists 30 days in advance of the event.

For instructions how to fill and sign this form electronically with Adobe Reader XI or higher, download and view the instruction document below. This is a free program you can get here if you don't have it. 
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The other option is to download it, fill it out and scan it to create a digital copy. Most copy shops can do this for you if you do not have the means to do this at home. Also be sure to submit the form to the proper facility. It is not recommended to send this using your own email as that is not a necessarily secure method. If you have someone else make a digital copy, you can still upload it to one of these forms.

If you have any questions on how to do this, ask for Help here.


Help!!
How to Fill and Sign LEIN Form with Adobe Reader
File Size: 712 kb
File Type: pdf
Download File

Download the LEIN form here. 
LEIN Form.pdf
File Size: 15 kb
File Type: pdf
Download File

    Submit LEIN for  here. Forms can also be turned in at the training meetings, submitted with the form below, or mailed to Jon Matteson, W 3669 Rogers Rd., Moran, MI 49740.

    Max file size: 20MB
Submit LEIN Clearance Form
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