Live Scan Service Request (Company Officers Directors Others) {LIC 051-CIU}

LIC 051-CIU, Live Scan Service Request (Company Officers, Directors, and Others), The California Department of Justice (DOJ) and Federal Bureau of Investigation’s (FBI) processing fees are to be paid by the license applicant or the officer’s/director’s company. Be prepared to pay fees at the time your fingerprints are taken at the live scan service provider site or submitted to Accurate Biometrics. Please prepare three copies of this form and distribute as follows: 1) First Copy (Original) to the Live Scan Provider; 2) Second Copy to Requesting Agency; 3) Third Copy to the Person being fingerprinted. If the applicant completes a 1033 Consent Waiver (18 U.S.C. §1033), that applicant is to make a Fourth Copy of this form and send it to the California Department of Insurance. www.FormsWorkflow.com