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Ox 29500 3320 Garner Road Bldg. 16A Raleigh, NC 27626-0500 Email to: CIISHelp ncdoj.gov Form Number FD 258 Fax To: (919) 661 - 4890 Description Quantity Applicant Fingerprint Card Federal Fingerprint Card: Public Law 105.277 Licensed/Certified Direct Patient Care * Order only if approved by SBI for PL 105.277 * Standard Criminal State and/or Federal Background Check Federal Fingerprint Card: SB41 2005 * * Order only if approved by SBI for SB41 -2005 * * FD 353 P.

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