The following referring agencies have made their Live Scan Request Forms available to the public online

The following referring agencies have made their Live Scan Request Forms available to the public online.

Blank Form:
Request For Live Scan Service Form - BCIA 8016 - State of California. Department of Justice.

Bureau of Security and Investigative Services (BSIS):

Live Scan - Forms

Select the Type of Certificate/License/Permit/Registration
for which you are applying:

DOJ Firearms Division - POST Certification
DOJ/Firearms Division - P.O.S.T. Certification (Non-Sponsored)

Entertainment Firearms Permit Application & Live Scan Form

Contractors State License Board
Contractors State License Board Information - You must bring the "Request for Live Scan Form" that you received from State License Board. We have the form for the "Request for Live Scan Form" but make sure you have your 11 Digit application number, if you do not have the form.

Department of Social Services:
CA Dept of Social Services - Use this form to obtain Live Scan for the Dept. of Social Services Related services - LIC 9163.

LIC279: Application For a Family Child Care Home License
LIC508: CRIMINAL RECORD STATEMENT

Education:
Applicant for Teacher Credential
California Commission on Teaching Credentialing

Gambling:
Gambling Card Room Key
Gambling Card Room Owner
Gambling Card Room Work Permit
Gambling Third Party
Tribal Gaming Key Employee
Tribal Gaming Vendor

Insurance:

California Department of Insurance: Live Scan Service Request (Applicant) LIC 442-39A (Rev. 09/2008) Form for Insurance service providers.

AGENTS & BROKERS: Producer Licensing Requirements

License Classes Listed in Alphabetical Order

Accident and Health Agent

Cargo Shippers' Agent

Communications Equipment Insurance Agent

Credit Insurance Agent

Fire and Casualty Broker-Agent

Insurance Adjuster

Interim Public Insurance Adjuster

Life Agent (Life-Only Agent, Accident and Health Agent)

Life and Disability Insurance Analyst

Life-Only Agent

Limited Lines Automobile Insurance Agent

Motor Club

Part-Time Fraternal Agent

Personal Lines Broker-Agent

Public Insurance Adjuster

Reinsurance Intermediary-Broker/ Intermediary-Manager

Rental Car Agent Licensing

Self-Service Storage Agent

Surplus Line Broker

Special Lines' Surplus Line Broker

Stock Agent

Title Marketing Representative

Travel Agent

Vehicle Service Contract Provider

Viatical Settlement Licenses

Healthcare/Medical/Psychological:
Acupuncture Board: Acupuncture License
Board of Behavioral Sciences: Marriage and Family Therapist, Clinical Social Worker, Educational Psychologist.
Board of Optometry: Optometrist
Board of Occupational Therapy, DCA: Occupational Therapist, Occupational Therapist Assistant.
Chiropractic
Dental Board of California - Dental License or Examination.
Doctor of Podiatric Medicine
Hearing AID Dispensers Bureau: Hearing Aid Dispenser - License, Certification, Permit
Naturopathic Doctor

Registered Nurse - Endorsement (DOJ + FBI) - Original
Registered Nurse - Examination (DOJ + FBI)

REGISTERED NURSE - RENEWAL (DoJ+FBI)

Vocational Nurse or Psychiatric Technician - Original

Vocational Nurse - Psychiatric Technician - Permit Renewal

Certified Nurse Assistant (CNA) or Home Health Aide (HHA)-Sample Form.
Use this Blank Form BCIA 8016 for CNA or HHA and use above form for the guidlines.

Certified Nurse Assistant/Home Health Aide/Hemodialysis Technician Forms

BCII 8016 Request for Live Scan Service BCIA 8016 SAMPLE Sample for Certification of Nurse Assistants or Home Health Aides Request for Live Scan Service Applicant Submission BCII 8016 SAMPLE Sample for Licensee, Administrator, and Direct Care Staff of ICFDD, ICFDDN, ICFDDH Facitities Request for Live Scan Service Applicant Submission

Paramedic - Emergency Medical Services Authority

Pharmacists - Section 4050
Pharmacy Intern - Section 4015
Pharmacy Technician - Section 4015
Pharmacy Wholesaler - Section 4305.5

Physical Therapist or Physical Therapist Assistant

Physician and Surgeon
Medical Board of California (MBC) -Physician and Surgeon, License, Certification, Permit - Licensing Form

Psychology

Respiratory Care Practitioner

Speech-Language Pathology and Audiology Board

Veterinarian or Veterinary Technician
Veterinary Medical Board: Veterinarian/Veterinary Technician - License/Certification.

Miscellaneous:

Cemetery and Funeral Bureau

City of Chino - Massage Therapy/Outcall Massage - Request for Live Scan Service Form.

Christian Athletic League, Riverside - Volunteer - Request for Live Scan Service Form.

Cal South - Non Profit Youth Organization Volunteer