Get TX Fingerprint Service Code Form

Department of Insurance Use Only Texas Fingerprint Service Code Form Service Name Dept. of Insurance To schedule your ten-minute fingerprint appointment simply visit https //uenroll.identogo. com and enter the following Service Code 11G6QF Service Code is unique to your hiring/licensing agency. Do not use this code for another purpose. Background Check Waiver I certify that all information I provided in relation to this criminal history record check is true and accurate. I authorize the Texas Department of Public Safety DPS to access Texas and Federal criminal history record information that pertains to me and disseminate that information to the designated Authorized Agency or Qualified Entity with which I am or am seeking to be employed or to serve as a volunteer through the DPS Fingerprint-based Applicant Clearinghouse of Texas and as authorized by Texas Government Code Chapter 411 and any other applicable state or federal statute or policy. I authorize the Texas Department of Public Safety to submit my fingerprints and other application information to the FBI for the purpose of comparing the submitted information to available records in order to identify other information that may be pertinent to the application* I authorize the FBI to disclose potentially pertinent information to the DPS during the processing of this application and for as long hereafter as may be relevant to the activity for which this application is being submitted* I understand that the FBI may also retain my fingerprints and other applicant information in the FBI s permanent collection of fingerprints and related information where all such data will be subject to comparisons against other submissions received by the FBI and to further disseminations by the FBI as may be authorized under the Privacy Act of 1974 5 USC 552a. I understand my fingerprints will be searched by and against civil criminal and latent fingerprints in the Next Generation Identification NGI system* I understand I am entitled to obtain a copy of any criminal history record check and challenge the accuracy and completeness of the information before a final determination is made by the Qualified Entity. I also understand the Qualified Entity may deny me access to children the elderly or individuals with disabilities until the criminal history record check is completed* If a need arises to challenge the FBI record response you may contact the agency that submitted the information to the FBI or you may send a written challenge request to the FBI s Criminal Justice Information Services CJIS Division at FBI CJIS Division Attention Correspondence Group 1000 Custer Hollow Road Clarksburg WV 26306. com and enter the following Service Code 11G6QF Service Code is unique to your hiring/licensing agency. Do not use this code for another purpose. Background Check Waiver I certify that all information I provided in relation to this criminal history record check is true and accurate. Do not use this code for another purpose. Background Check Waiver I certify that all information I provided in relation to this criminal history record check is true and accurate. I authorize the Texas Department of Public Safety DPS to access Texas and Federal criminal history record information that pertains to me and disseminate that information to the designated Authorized Agency or Qualified Entity with which I am or am seeking to be employed or to serve as a volunteer through the DPS Fingerprint-based Applicant Clearinghouse of Texas and as authorized by Texas Government Code Chapter 411 and any other applicable state or federal statute or policy. .