Get NY HAZ-600 2017-2024

Ethnicity o Hispanic Skin Tone Zip Code Hair Color o Unknown Eye Color Place of Birth Country Country of Citizenship Alien Registration Number If applicable PAGE 1 OF 2 HAZ-600 7/15 reset/clear INSTRUCTIONS Federal and state laws require that commercial drivers who apply for a hazardous materials hazmat endorsement be fingerprinted as part of the qualification procedure. REQUEST FOR NYS FINGERPRINTING SERVICES - INFORMATION FORM Before completing this form please read the instructions on page 2 Important Information About FBI Record Checks Your fingerprints will be used to check the criminal history records of the FBI. You have the right to review the information on your FBI record. If you believe your record is incorrect or incomplete you can request that it be changed corrected or updated* For more information and instructions visit the FBI web site at http //www. fbi. gov/about-us/cjis/criminal-history-summary-checks. You need this information to schedule your appointment to be fingerprinted ORI CONTRIBUTOR AGENCY JOB OR LICENSE TYPE NYSHAZMAT NYS Department of Motor Vehicles HazMat Driver Section 1 Carrier Information Billing Account Number If applicable Section 2 Applicant Information License ID Number Enter the 9-digit number from the NYS commercial driver license. Name of Applicant Enter the name exactly as it appears on the applicant s NYS commercial driver license Last First Middle Suffix Alias/Maiden Name If applicable Home Address Street and Name City State Daytime Phone Type Daytime Phone Number Area Code o Cell Date of Birth Month Age Day Race Year o Home o Work Gender o Pager o Other Height o Male o Female Feet Inches lbs. The required fingerprinting service is being provided by MorphoTrust Enrollment Solutions MorphoTrust. All hazmat endorsement applicants must be fingerprinted at one of the MorphoTrust ID centers located throughout New York State. Fingerprinting is done by appointment. Selecting a fingerprinting location scheduling an appointment and getting information about the required fee can be done online at www. identogo. com or by calling 1-877-472-6915. This form must be completed as described below and taken to the fingerprinting site at the time of the appointment. In addition to this form the applicant must bring two acceptable proofs of identification acceptable proofs are listed below under Acceptable Documents for Proof of Identity. an escrow account with MorphoTrust the carrier must provide the escrow account number in the Billing Account Number field. commercial driver license or an Interim NYS commercial driver license accompanied by a NYS non-commercial photo license in order to apply for the hazmat endorsement. NOTE The applicant s name and date of birth written on this form must exactly match the name and date of birth as it appears on the NYS commercial driver license. ACCEPTABLE DOCUMENTS FOR PROOF OF IDENTITY Applicants MUST bring two 2 proofs of identification to the fingerprinting site 1. The first proof must be a valid NYS photo commercial driver license or an interim NYS commercial driver license accompanied by a NYS non-commercial photo driver license.