Get Criminal Record Exemption Transfer Request - California Department ... - Dss Cahwnet

The Criminal Record Exemption Transfer Request form is essential for transferring active criminal record exemptions between licensed facilities in California. This guide provides clear instructions for completing the form online, catering to users with varying levels of experience.

Follow the steps to complete the transfer request form effectively.

1. Click ‘Get Form’ button to obtain the form and open it in an online document management system.
2. Enter the date at the top of the form for reference.
3. Provide the full name of the individual requesting the exemption transfer. This includes the last name, first name, and middle initial.
4. Input the individual’s CA driver’s license or ID number, or their permanent resident ID (I-551).
5. Fill in the date of birth (DOB) to confirm identity.
6. Include the licensing information system ID number associated with the individual.
7. The Social Security Number (SSN) is optional but can be provided if the individual chooses.
8. Specify the facility or organization from which the exemption is being transferred. Include the facility's name, number, street address, city, state, and zip code.
9. Indicate the facility or organization to which the exemption is being transferred, following the same format as above.
10. Select the type of association the transferee has with the new facility/organization such as employee, partner, etc.
11. Provide the date of employment for the transferee at the new facility.
12. Sign at the bottom of the form, certifying that identity verification and the required documents are enclosed. Ensure to indicate the title to denote your role.
13. After completing all fields, save the changes, download the form, print it, or share it as necessary.

Complete your Criminal Record Exemption Transfer Request online to ensure a smooth transfer process.