Your Name/Name
Address
Postal Code/City
National Criminal Record
44317 Nantes Cedex 3
Done; [your city], on [specify date].
Request for an extract of my criminal record
Madam, Sir,
I hereby request that you send me an extract of my criminal record to the address indicated above. For your information, I was born on [indicate your date of birth] and [indicate your place of birth].
Waiting for this, please accept, Madam, Sir, my best regards.
[Your signature]