Get Ucia Fingerprint Consent Form Illinois

Filling out the Ucia Fingerprint Consent Form is an essential step for applicants involved in the medical cannabis dispensing application process in Illinois. This guide provides clear instructions on how to complete the form online, ensuring that you provide all necessary information accurately.

Follow the steps to complete your Ucia Fingerprint Consent Form online.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Review the facility information section. This section requires you to fill in the purpose code, the requesting agency ORI identifier, and the agency's name and address for the Illinois Department of Financial and Professional Regulation.
3. Complete the applicant information section. You will need to provide your name, gender, Social Security Number (SSN), driver's license number, race, date of birth (in mm/dd/yyyy format), driver's license state, and registry ID number.
4. Fill out the live scan vendor/appointment information section, which includes the vendor's name, address, phone number, and your appointment date and time.
5. Read the privacy statement carefully. This section authorizes the release of your criminal history record information and details your rights regarding inaccuracies in your records.
6. Sign and date the applicant consent section, providing both a printed name and a signature along with the date.
7. After completing all sections, review your information for accuracy. Save any changes made to the form, and then choose to download, print, or share your completed form as needed.

Complete your Ucia Fingerprint Consent Form online today to streamline your application process.