FINGERPRINT CARD

FINGERPRINT CARDLAST NAMEFIRST NAMEMIDDLE NAMESR; JR; OF BIRTHPLACE OF BIRTHSOCIAL SECURITY OF PERSON FINGERPRINTEDRESIDENCE OF PERSON FINGERPRINTEDDATESIGNATURE OF PERSON TAKING FINGERPRINTSPRINTED NAME OF PERSON TAKING FINGERPRINTS1. RIGHT THUMB2. RIGHT INDEX3. RIGHT MIDDLE4. RIGHT RING5. RIGHT LITTLE6. LEFT THUMB7. LEFT INDEX8. LEFT MIDDLE9. LEFT RING10. LEFT LITTLELEFT FOUR FINGERS TAKEN SIMULTANEOUSLYL. THUMBR THUMBRIGHT FOUR FINGERS TAKEN SIMULTANEOUSLYN otes:1. Based on FBI Criminal Justice Information Services Division FINGERPRINT card : FD-258 Applicant You may be asked to use this or another card to take fingerprints . Please print on card stock Parent or Guardian - Consider keeping this FINGERPRINT card in a safe place.

1. Based on FBI Criminal Justice Information Services Division Fingerprint Card: FD-258 Applicant Card. 2. You may be asked to use this or another card to take fingerprints. Please print on card stock paper. 3. Parent or Guardian - Consider keeping this fingerprint card in a safe place.

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cca.hawaii.gov

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