Loading
Get Ca Lic 9163 2015-2026
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the CA LIC 9163 online
The CA LIC 9163 form is essential for individuals seeking to complete a Live Scan service in the community care licensing sector in California. This guide will provide clear, step-by-step instructions for effectively completing this form online, ensuring users can navigate through the process with ease.
Follow the steps to accurately complete the CA LIC 9163 online
- Click ‘Get Form’ button to obtain the CA LIC 9163 form and open it in your editor.
- In the ORI field, confirm the preprinted information: A0448.
- Select your working title by checking one of the boxes: Adult Resident other than Client, Employee, License/Certification Applicant, Volunteer, or Home Care Aide Registry Applicant.
- For Authorized Applicant Type, refer to the list on Page 2 and enter the DOJ abbreviated facility/type corresponding to your working environment.
- Fill in the contributing agency information. Select the authorized agency receiving criminal history information, confirming it is CA Dept of Social Services and inputting the Mail Code 03502.
- Provide your full applicant information, including your name, any other names used (AKA's), date of birth, sex, height, weight, California Driver's License number, and any other identifying information required.
- Complete your home address, including street, city, state, and zip code.
- In the Facility/Organization Number field, input the facility number you have been assigned.
- Choose your level of service, which is preprinted as DOJ or FBI.
- Fill out employer information if applicable by listing the employer's name, address, and telephone number.
- The Live Scan transaction will be completed by the operator; take two copies of the form with you for fingerprinting. The operator will fill out the final section of the form.
- Once completed, review all entries for accuracy before saving your changes, downloading, printing, or sharing the form.
Complete your CA LIC 9163 form online today for a seamless Live Scan service experience.
The Live Scan form for Identogo is utilized for scheduling and processing background checks. When using CA LIC 9163, this form gathers essential applicant information and identifies the purpose of the Live Scan. Utilizing platforms like USLegalForms can simplify the process, ensuring that all necessary information is collected and submitted correctly.
Industry-leading security and compliance
US Legal Forms protects your data by complying with industry-specific security standards.
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.