Transcription of REQUEST FOR LIVE SCAN SERVICE Applicant …
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Example: dental hygienist
REQUEST FOR LIVE SCAN SERVICE Applicant …
7. NOTE: NOT APPLICABLE FOR TRUSTLINE APPLICANTSE mployer: (Additional response for Department of Social services , DMV/CHP licensing, and Department of Corporations submissions only)Employer NameStreet No. Street or PO BoxMail Code (five digit code assigned by DOJ)City State Zip CodeAgency Telephone No. (Optional)4. Agency Address Set Contributing Agency:Agency authorized to receive criminal history informationMail Code(five-digit code assigned by DOJ)Street or PO BoxContact Name(Mandatory for all school submissions)CityState Zip CodeContact Telephone Type of Application: (Check one) Employment License, Certification, Permit VolunteerSTATE OF C
guidelines for community care licensing (ccld) applicants who use a live scan site (ccld or doj site) for fingerprinting instructions for the lic 9163
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REQUEST FOR LIVE SCAN SERVICE - COMMUNITY, Community, LIVE SCAN, CALIFORNIA - HEALTH AND HUMAN, California - health and human services agency california department of social services community, Ruth Ann Terry, MPH, RN, Scan, Nebraska, Request, BACKGROUND SCREENING Application for, Background Checks in the Hiring Process