DD3058 Executive Services Directorate, FORM INFORMATION Form Number DD 3058 Title Department of Defense Consent to Conduct Installation Records Check IRC Edition Date 10 11 2019 Authority DoDI 1402 05 For use of this form please contact The Under Secretary of Defense for Personnel and Readiness P R . Department of the Air Force E Publishing Publications Forms AF, The official website for Air Force e Publishing
.Dd Form 3058
Dd Form 3058
DD3058 Executive Services Directorate
FORM INFORMATION Form Number DD 3058 Title Department of Defense Consent to Conduct Installation Records Check IRC Edition Date 10 11 2019 Authority DoDI 1402 05 For use of this form please contact The Under Secretary of Defense for Personnel and Readiness P R .
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The DD Form 3058 authorizes consent to conduct Installation Records Checks on individuals who provide childcare services as defined by 34 U S C 20351 Child Care Worker Employee Background Checks Requirements for Background Checks The form is used to collect information regarding an individual s criminal history which encompasses military law enforcement records the Defense Central Index of .
https://www.100fss.com/document-manager/youth-sports/551-dd3058/file/
DD Form 3058 is a document that authorizes the Department of Defense to conduct a background check on individuals who provide child care services It contains personal information authorization and release certification and signature of the subject or parent legal guardian
https://www.esd.whs.mil/Directives/forms/dd3000_3499/DD3058/
FORM INFORMATION Form Number DD 3058 Title Department of Defense Consent to Conduct Installation Records Check IRC Edition Date 10 11 2019 Authority DoDI 1402 05 For use of this form please contact The Under Secretary of Defense for Personnel and Readiness P R
DD Forms 3000 3499 updated 1 8 2025 Executive Services Directorate
Form Availability If the form number does not have a hyperlink the form is not available electronically To obtain hard copies of current forms not available in electronic format please contact your own Military Service or DoD Component Forms Management Officer Cancelled forms are not available in electronic formats Here is a list of Forms Management POCs If you have trouble accessing any .
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span class result type PDF span Prescribed by DoDI 1402 05 CUI when filled in
CUI when filled in Controlled by OUSD P R CUI Category PRVCY Distribution Dissemination Control FEDCON POC osd pentagon ousd p r mbx forms mail mil.
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The DD 3058 is initiated and completed by the applicant at the office or installation staff responsible for the oversight of individuals who provide services to children It is important to note that this is not a childcare form but rather a form for individuals who work on an installation with children .
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