Follow the steps to complete the exemption request form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin filling out the applicant’s name at the top of the form. Ensure that you type or print clearly, providing your last name, first name, and middle initial as required.
3. Enter your home address in the designated section. Include your street address, city, state, and zip code to ensure accurate contact information.
4. Provide the name of your employer or the licensing agency associated with your request. This information helps in validating the purpose of the exemption.
5. Indicate the basis for your exemption. Select either 'No regional access (> 75 miles) to electronic fingerprinting services' or 'Other.' If you choose 'No regional access,' provide the details of the nearest electronic fingerprint site, including the business name and address.
6. Include any other specific information relevant to your exemption request under 'Other (see information sheet).' Use this space to give any additional context if necessary.
7. Review the certification statement declaring that the information provided is true and correct, then sign your name in the designated area.
8. Finally, add the date of your signature. After completing all sections, save your changes, and ensure you have your fingerprint card(s) ready to mail together with this form.

Start filling out your request for exemption form online today to ensure your request is processed smoothly.