Transcription of BCIA 8016RR - REQUEST FOR LIVE SCAN - Attorney General of ...
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BCIA 8016RR - REQUEST FOR LIVE SCAN - Attorney General of ...
Applicant SubmissionORI (Code assigned by DOJ)Type of Application (Check One Only)Record ReviewForeign AdoptionReason for ApplicationContributing Agency Information:Agency Authorized to Receive Criminal Record InformationStreet Address or BoxCityStateZIP CodeMail Code (five-digit code assigned by DOJ)Contact Name (mandatory for all school submissions)Contact Telephone NumberApplicant Information:Last NameFirst NameMiddle InitialSuffixOther Name (AKA or Alias)LastFirstSuffixDate of BirthSexMaleFemaleDriver's License NumberMisc. Number (Other Identification Number)HeightWeightEye ColorHair ColorPlace of Birth (State or Country)Social Security NumberTelephone NumberStreet Address or BoxCityStateZIP CodeLevel of Service: DOJ OnlyIf re-submission, list original ATI number (Must provide proof of rejection):Original ATI NumberForeign Government Embassy: (Mandatory for Foreign Adoption requests pursuant to Penal Code section 11105(c)(12))Desig
or naturalization matter, security clearance, or adoption), you have certain rights which are discussed below. • You must be provided written notification ... You have the right to expect that officials receiving the results of the criminal history record check
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