Welcome! This is an official order form for fingerprinting services. You must completely and accurately fill-out this application to be considered for finrgerprinting. 

Applicant Information:

Previous Last Name Previous First Name Previous Middle Name

Information Related To Your Birth:


Demographic Information:

feet inches

Current Residence Address: (this may be different than your mailing address)

Present Mailing Address: (if different from residence address)

Work Information And Address: (enter your place of employment)


Telephone Number: (###-###-####)

Email:

Please Create A Password: (you can use this to track progress, and we may need to contact you during the process)

Password Information: In order to comply with CJIS standards we have employed the use of a password complexity monitor. As you enter your password, we will display an indicator of complexity. You will only be able to submit passwords that are sufficiently complex as to be considered 'safe' by CJIS standards. The visual indicator will turn Blue or Green to indicate that your password is safe.

Important: CJIS requires we maintain a strict password policy and system of checks. As such, we check the following items as you enter your new password:
  • The password must be a minimum length of eight (8) characters on all systems
  • The password must not be a dictionary word
  • The password must not be the same as your email address
  • The password must not be a proper name

Reason for Request of Fingerprinting:


Total Fee:

$0

I DO HEREBY CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I ALSO UNDERSTAND THAT ANY FALSIFICATION OF THE ABOVE INFORMATION WILL RESULT IN THE REFUSAL TO COMPLETE THE PROCESS OF FINGERPRINTING.

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You Must Select An Appointment: your appointment will be confirmed prior to checkout

To Reserve An Appointment Select The Date & Time Below
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I accept and assume all responsibility and liability for, injury to, or death of any person, or damage to any property which may result through an act or omission of either the licensee or the agency that issued the license. In the event any claim, suit or action is brought against the agency that issued the license, its chief officer or any of its employees, by reason of, or in connection with any such act or omission, the licensee shall defend, indemnify, and hold harmless the agency that issued the license, its chief officer or any of its employees from such claim, suit, or action.

I understand that the acceptance of any application by the licensing authority does not guarantee the issuance of a license and that fees and costs are not refundable if denied. I further understand that if my application is approved and I am issued a license to carry a concealed weapon, that the license is subject to restrictions placed upon it and that misuse of the license will cause an automatic revocation and possible arrest and that the license may also be suspended or revoked at the discretion of the licensing authority at any time. I am aware that any use of a firearm may bring criminal action or civil liability against me.

I have read, understand, and agree to the CCW license liability clauses, conditions, and restrictions stated in this application and Agreement to Restrictions and to Hold Harmless.

I have read and understand the applicable Penal Code sections regarding false statements on a CCW Application, manslaughter, killing in defense of self or property, limitation on self-defense and defense of property, and child access and firearm storage, stated in this application.

I have read and understand the Firearms Prohibiting Categories attachment to this application. I further acknowledge that these prohibiting categories can be amended or expanded by state or federal legislative or regulatory bodies and that any such amendment or expansion may affect my eligibility to hold a CCW license.

I herby give permission to the agency to which this application is made to conduct a background investigation of me and to contact any person or agency who may add to or aid in this investigation. I further authorize persons, firms, agencies and institutions listed on this application to release or confirm information about me and statements I have made as contained in this application.

Notwithstanding any other provision of law and pursuant to the Public Records Act (Government Code section 6250 et seq.), I understand that information contained in this application may be a matter of public record and shall be made available upon request or court order. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

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