Wisconsin Convictions and Pending Charges Form
The Wisconsin Convictions and Pending Charges Form (#2252) is essential for individuals seeking professional credentials. It outlines necessary disclosure of criminal records and instructions for submission. Proper completion ensures timely processing of your application.
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How do I fill this out?
To fill out this form, carefully read the instructions provided and ensure all required documentation is included. Gather necessary information about your criminal history, including any pending charges and previous convictions. Be thorough and accurate to avoid delays in processing your application.

How to fill out the Wisconsin Convictions and Pending Charges Form?
1
Read the instructions thoroughly.
2
Gather your criminal history documentation.
3
Complete all required fields on the form.
4
Attach necessary documents and fees.
5
Submit the form to the appropriate department.
Who needs the Wisconsin Convictions and Pending Charges Form?
1
Aspiring Aestheticians applying for a license.
2
Individuals with prior convictions seeking to work in health services.
3
Barbers and Cosmetologists renewing their practice licenses.
4
Private Security Personnel aiming for credential approval.
5
Nurses needing to disclose past criminal records for licensure.
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What are the instructions for submitting this form?
To submit this form, send it via mail to the Department of Safety and Professional Services at P.O. Box 8935, Madison, WI 53708-8935. You may also submit your application and supporting documents online if applicable. Ensure to include all necessary documentation and payment information with your submission to avoid processing delays.
What are the important dates for this form in 2024 and 2025?
In 2024, ensure to submit your applications by the designated deadlines to avoid any processing delays. For 2025, check for updated guidelines and fees associated with this form. Keep an eye on the Department's website for any new announcements regarding submission dates.

What is the purpose of this form?
The primary purpose of this form is to ensure that individuals seeking professional credentials in Wisconsin disclose necessary background information regarding criminal convictions and pending charges. This requirement is mandated by state regulations to safeguard public trust in licensed professionals. Accurate information on this form will determine the approval or denial of your application, ultimately impacting your eligibility for licensing.

Tell me about this form and its components and fields line-by-line.

- 1. Profession: Select your professional category such as Aesthetician or Nurse.
- 2. Application/License Number: Provide your current application or license number.
- 3. Last Name: Enter your last name as it appears on official documents.
- 4. Date of Birth: Fill in your date of birth for identity verification.
- 5. Social Security Number: Your Social Security Number must be provided.
- 6. Fees: Indicate applicable processing and review fees.
What happens if I fail to submit this form?
Failure to submit this form can result in denial of your application for credentialing. Any omitted information may be considered a false statement leading to further complications. It is critical for applicants to adhere to all submission guidelines for timely processing.
- Delayed Processing: Incomplete submission may lead to significant delays.
- Application Denial: Failure to disclose required information could result in denial.
- Legal Consequences: Providing false information may have legal repercussions.
How do I know when to use this form?

- 1. Initial Licensure: Use this form when applying for the first time.
- 2. Renewal Applications: Necessary for renewing professional licenses.
- 3. Predetermination Follow-Up: Required for those who have received a favorable predetermination decision.
Frequently Asked Questions
What is the purpose of this form?
The form collects details about criminal history for credentialing purposes.
Who needs to submit this form?
Any individuals with convictions or pending charges seeking licenses in Wisconsin.
How do I fill out this form?
Follow the provided instructions, and ensure accurate information is submitted.
What happens if I forget to include documents?
Incomplete submissions may delay your application process.
Can I edit this PDF file?
Yes, you can easily edit the PDF using PrintFriendly's tools.
Is there a fee for submitting this form?
Yes, there may be application fees, including a $8.00 review fee.
How can I check my application status?
Contact the Department directly for information regarding your application.
Are there deadlines for submission?
It's best to submit as soon as possible to avoid delays.
How do I submit the form?
You can submit the form either via mail or online following the provided instructions.
What do I do if I have further questions?
Refer to the FAQ section or contact customer support for assistance.