State of California Live Scan Service Request Applicant LIC 442-39A Rev. 04/2013 Department of Insurance Attention 1033 Consent Waiver 18 U.S.C. If the applicant completes a 1033 Consent Waiver 18 U.S.C. 1033 that applicant is to make a Third Copy of this form and send it to the California Department of Insurance. 1033 Applicants The California Department of Justice DOJ and Federal Bureau of Investigation s FBI processing fees are to be paid by the license applicant. Be prepared to pay the fees at the time your fingerprints are taken at the license scan service provider site. The applicant is to make two copies of this form and distribute as follows 1 First Copy Original to the Live Scan Provider 2 Second Copy to the Applicant. Part 1 Applicant s Personal Information Please type or print clearly the information below Applicant Name Last First and Middle Former Name/AKA s Last First Date of Birth MM/DD/YYYY Gender Male Female Height Eye Color Hair Color Place of Birth Social Security Nu....
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How to fill out the Cdi Live Scan Request Form Lic 442 39a online
Completing the Cdi Live Scan Request Form Lic 442 39a online is essential for applicants seeking licensing through the Department of Insurance in California. This guide outlines the necessary steps to fill out the form accurately and efficiently, ensuring that all required information is provided.
Follow the steps to fill out the form correctly:
- Click the ‘Get Form’ button to access the Live Scan Request Form Lic 442 39a and open it in a digital editor.
- Begin filling out the form by entering your personal information in Part 1. Clearly type or print your name (last, first, middle), any former names or aliases, date of birth in MM/DD/YYYY format, gender, height, weight, eye color, hair color, place of birth, social security number, driver’s license number, and daytime telephone number.
- Provide your complete residence address, including street or P.O. Box, city, state, and zip code.
- Leave Part 2 blank; this section will be completed by the contributing agency.
- Skip to Part 3, which will be filled out by the live scan vendor after your fingerprinting is completed. Ensure you have your fingerprinting done at an authorized location.
- If you need to complete Part 4, do so only if you're resubmitting fingerprints. This will also be filled out by the live scan provider.
- Once all required sections are completed, review the form for accuracy. Save your changes and make sure to keep a copy for your records.
- You can download, print, or share the completed form as needed.
Start completing your Cdi Live Scan Request Form Lic 442 39a online today for an efficient document submission process.
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Get answers to your most pressing questions about US Legal Forms API.
How do I request a DOJ Live Scan?
Individuals can obtain a Request for Live Scan form LIC 9163 or from any local Community Care Licensing Division office.
How do I complete a Live Scan request?
You need to write personal information on a live scan form. That includes your full name, date of birth, address, eye color, weight, height, driver's license number, etc. That section is easy, but a technician can't fill this data for you. You're the only person who can.
How do I fill out a Live Scan request?
0:31 2:23 Number you can go ahead and leave that blank it does not apply. But be sure to include the eye.MoreNumber you can go ahead and leave that blank it does not apply. But be sure to include the eye. Color the hair color the place of birth. And the social security number or item.
What is CDL on Live Scan form?
What does "CDL No." on my Live Scan form mean? CDL No. stands for California driver's license number. You need to write in your California driver's license number in the space provided.
How much does it cost to get a Live Scan in California?
Live Scan Fees Type of License / ApplicationRolling FeeTotal FeeAdult Residential Care Facility$20$79Alcohol & Beverage Control Lic$20$20Ambulance Driver (DMV)$20$52California Lottery Retailer$20$2028 more rows
How much is a DOJ Live Scan?
What is the fee for Live Scan fingerprinting? The fees for Live Scan include a $49 processing fee ($32 DOJ and $17 FBI) plus a rolling fee.
How do I contact DOJ about background check?
24-hour Automated Telephone Service Available: (916) 227-4557. If a requesting agency does not have results within seven days and digital Live Scan fingerprints were submitted, you may use the automated telephone system to check on your submission.
How much does a Live Scan cost Los Angeles?
$17 Federal Bureau of Investigation (FBI) Fee (if required)
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