Get CA BSIS Renewal Application 2013

O. Box 989002 West Sacramento CA 95798-9002 916 322-4000 www. bsis. ca.gov RENEWAL APPLICATION Security Guard or Patrolperson 35 Fee Enclosed Delinquent Renewal 60 expired for no more than 60 days Proprietary Private Security Officer 35 Expiration Date Alarm Agent 7 Registration This request will not be processed without this number. STATE OF CALIFORNIA BUSINESS CONSUMER SERVICES AND HOUSING AGENCY GOVERNOR EDMUND G* BROWN JR* BUREAU OF SECURITY AND INVESTIGATIVE SERVICES P. Locksmith 20 Repossessor Agent Employee 60 Please type or print legibly Name Last Address First Number and Street Middle City State Date of Birth / Zip Code Home Phone Number Check here if this is a new residence address not already reported to the Bureau. Employer Name Employer Address Do you possess a valid firearms qualification card Signature Employer Phone Number If yes list your number Date INSTRUCTIONS FOR COMPLETING RENEWAL APPLICATION Use the numbered instructions below to complete this renewal form* Check the type of registration you are renewing. Note the expiration date from your current registration card. It is recommended that you submit your renewal at least three months prior to the expiration but no sooner than six months. If your registration has expired you must pay the applicable delinquency fee. Print your entire registration number including the prefix. Print your date of birth. Print your name address city state ZIP code and telephone number including area code. The telephone number will be used to call you in case of any problem with your renewal* 6. Print the name address and telephone number of your current employer. If not currently employed as a security guard alarm agent proprietary private security officer or locksmith indicate unemployed* Disregard this section if you are a If your address is new and has not been reported to the Bureau indicate by checking the box. If you have a valid firearms qualification card print the card number two-letter prefix and numbers. Sign and date application* 10. Send your application and fee to the Bureau of Security and Investigative Services P. O. Box 989002 West Sacramento CA 95798. ALL ITEMS MUST BE COMPLETE AND THE APPROPRIATE FEES ATTACHED OR THE APPLICATION MAY BE RETURNED Revised 03/2013. Locksmith 20 Repossessor Agent Employee 60 Please type or print legibly Name Last Address First Number and Street Middle City State Date of Birth / Zip Code Home Phone Number Check here if this is a new residence address not already reported to the Bureau. Employer Name Employer Address Do you possess a valid firearms qualification card Signature Employer Phone Number If yes list your number Date INSTRUCTIONS FOR COMPLETING RENEWAL APPLICATION Use the numbered instructions below to complete this renewal form* Check the type of registration you are renewing. Employer Name Employer Address Do you possess a valid firearms qualification card Signature Employer Phone Number If yes list your number Date INSTRUCTIONS FOR COMPLETING RENEWAL APPLICATION Use the numbered instructions below to complete this renewal form* Check the type of registration you are renewing. Note the expiration date from your current registration card. It is recommended that you submit your renewal at least three months prior to the expiration but no sooner than six months. .