We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Uncategorized Forms
  • Cjis 9004, Request For Exemption From Mandatory Electronic Fingerprint Submission Requirement

Get Cjis 9004, Request For Exemption From Mandatory Electronic Fingerprint Submission Requirement

STATE OF CALIFORNIA CJIS 9004 (Rev. 01/2013)DEPARTMENT OF JUSTICEREQUEST FOR EXEMPTION FROM MANDATORY ELECTRONIC FINGERPRINT SUBMISSION REQUIREMENTBureau of Criminal Identification and Analysis P.O.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the CJIS 9004, Request For Exemption From Mandatory Electronic Fingerprint Submission Requirement online

The CJIS 9004 form is a crucial document for individuals seeking an exemption from the mandatory electronic fingerprint submission requirement in California. This guide will provide clear and supportive instructions on how to fill out this form accurately online.

Follow the steps to successfully complete the CJIS 9004 form online.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin filling in the applicant's name. Clearly enter your last name, first name, and middle name in the designated fields.
  3. Proceed to the applicant's address section. Type your street address, city, county, state, and ZIP code, ensuring all information is accurate and clearly presented.
  4. In the basis for exemption section, select the reason for your request. You may indicate 'No regional access to fingerprinting services' by specifying the nearest electronic fingerprint site and its business name. If applicable, use the 'Other' option to explain that the applicant resides outside of California.
  5. Certify that the information provided is true and correct by signing your name in the designated signature field. Ensure you also enter the date of your signature.
  6. Once you have completed filling out the form, you can save changes, download the document, or print it directly from the editor for mailing to the provided addresses.

Complete your documents online today to ensure a smooth submission process.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

request for exemption from mandatory electronic...
Department of Justice. REQUEST FOR EXEMPTION FROM. MANDATORY ELECTRONIC FINGERPRINT...
Learn more
December 23, 2017 (Pages 7667-7822) - Digital...
Dec 23, 2017 — Ambulatory surgical facilities; requests for excep- ... The required...
Learn more

Related links form

State Of Connecticut Agency Vendor Form W 9 Notarized Connecticut Form Ct Online Certificate Of Incorporation Form Ol15c 2020

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

Contrary to popular belief, it does not need to be filled out by a law enforcement agency. In fact, nearly all FD-258 cards submitted with NFA purchases are done by the user themselves! We will give you some helpful instructions so you can successfully complete your FD-258 Fingerprint Card.

Title 16, California Code of Regulations, Sections 1419, 1419.1, and 1419.3 require the submission of fingerprints when a nurse renews his or her California nursing license if the licensee was not previously fingerprinted by the Board or if a record of fingerprint submission no longer exists.

GUIDE FOR COMPLETING YOUR FD-258 CARD. **Do not write on the card until you check with your fingerprinting location. ... 1 Name. Last, First, Middle. 2 Aliases Enter all former names/aliases. ... 3 ORI number. ... 4 Date of Birth. ... 6 Demographic information. ... 7 Place of Birth. ... 8 Social Security Number.

Contact Us Application status updates can be found by visiting our Application Status and Details page, by emailing BRN.Licensing@dca.ca.gov or by calling the BRN main line at (916) 322-3350. Please review the BRN's application timeframes for initial review prior to reaching out to BRN staff.

AKA-ALIASES – All other names used in the past including maiden names and previous legal names (no nicknames).

Please do not fold the fingerprint card. Please use a 9” X 12” envelope to return your completed fingerprint card with fee. Write “DO NOT FOLD” on the envelope. If your card is folded, you may be required to complete and submit a new fingerprint card.

All of the above items should be mailed directly to the Board by the individual(s) or agency who is providing information about the applicant. Have these items sent to the Board of Registered Nursing, Licensing Unit, P.O. Box 944210, Sacramento, CA 94244-2100.

Fingerprint Requirement for License Renewal Type of Results and Timeframes: FAX Live Scan form to: ATTN: Fingerprint Unit. (916) 574-8647. MAIL Live Scan form to: Board of Registered Nursing. ATTN: Fingerprint Unit. 1747 N. ... MAIL FD-258 Fingerprint Card with $49 payment to: Board of Registered Nursing. ATTN: Fingerprint Unit.

0:27 3:24 How To Fill Out an FD-258 Fingerprint Card - YouTube YouTube Start of suggested clip End of suggested clip Color the blocks marked with x should be left. Out. Here are the areas that need to be filled. FillMoreColor the blocks marked with x should be left. Out. Here are the areas that need to be filled. Fill out the signature of the subject in block. One followed by the residential. Address in block.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get CJIS 9004, Request For Exemption From Mandatory Electronic Fingerprint Submission Requirement
Get form
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232