Transcription of BCIA 8016, Request for Live Scan Service - State of …
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BCIA 8016, Request for Live Scan Service - State of …
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.
Title: BCIA 8016, Request for Live Scan Service Author: California Department of Justice, California Justice Information Services Division, OSP Subject
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