Transcription of REQUEST FOR LIVE SCAN SERVICE
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REQUEST FOR LIVE SCAN SERVICE
STATE OF CALIFORNIADEPARTMENT OF JUSTICEBCIA 8016 (orig. 04/2001; rev. 01/2011) 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 BoxCityStateZIP 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 BoxCityStateZIP CodeBilling Number(Agency Billing Number)Misc.
STATE OF CALIFORNIA DEPARTMENT OF JUSTICE BCIA 8016 (orig. 04/2001; rev. 01/2011) REQUEST FOR LIVE SCAN SERVICE Applicant Submission ORI (Code assigned by DOJ) Authorized Applicant TypeType of License/Certification/Permit OR Working Title (Maximum 30 characters - if assigned by DOJ, use exact title …
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