Follow the steps to fill out the Lic 9163 form online.

1. Click the ‘Get Form’ button to obtain the Lic 9163 form, which you can open in your preferred online editor.
2. Locate the ORI field at the top of the form, which is preprinted as 'A0448'. Verify this information is correct.
3. In the Working Title section, check the box that corresponds with your role: 'Adult Resident other than Client', 'Employee', 'License, Certification, Applicant', or 'Volunteer'.
4. For the Authorized Applicant Type, refer to page 2 of the document to choose the facility type where you will be working. Enter the corresponding DOJ abbreviated facility type.
5. Fill in the Agency Address, which is preprinted as the CA Department of Social Services. Include the Mail Code and ensure the contact details are accurate.
6. Complete the Applicant Information section by printing your full name, date of birth, sex, height, weight, and California driver's license number. Also, include any other miscellaneous identification numbers, including a social security number if applicable.
7. Enter the Facility Number in the designated section. If applicable, indicate the level of service required and any previous ATI numbers if this is a resubmission.
8. Fill out the Employer section with the employer's name, address, and optional telephone number if you are being printed for a specific employer.
9. The Live Scan transaction information will be completed by the Live Scan operator. Remember to take the completed form with you on your fingerprinting day.
10. After filling out the form, review all entries for accuracy. You can then save your changes, download the form, print it, or share it as necessary.

Complete your documents online today for a smoother processing experience.