Transcription of BCIA 8016 - Request for Live Scan Service
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BCIA 8016 - Request for Live Scan Service
Applicant SubmissionORI (Code assigned by DOJ)Authorized Applicant TypeType of License/Certification/Permit OR Working Title (Maximum 30 characters - if assigned by DOJ, use exact title assigned)Contributing Agency Information:Agency Authorized to Receive Criminal Record InformationMail Code (five-digit code assigned by DOJ)Street Address or BoxCityZIP CodeContact Name (mandatory for all school submissions)Contact Telephone NumberApplicant Information:Last NameFirst Name Middle InitialSuffixOther Name (AKA or Alias)LastFirstSuffixDate of BirthSexMaleFemaleDriver's License NumberHeightWeightEye ColorHair ColorPlace of Birth (State or Country)Social Security NumberHome AddressStreet Address or BoxCityZIP CodeBilling Number(Agency Billing Number)Misc.
STATE OF CALIFORNIA DEPARTMENT OF JUSTICE BCIA 8016 PAGE 1 of 4 (Rev. 04/2020) REQUEST FOR LIVE SCAN SERVICE (If the Level of Service indicates FBI, the fingerprints will be used to check the criminal history record information of the FBI.) State State State Date
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