Fingerprints Applicant Request Form - Government Of Canada

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Fingerprints applicant request form
Contract Security Program
To: Personnel security screening applicant
A criminal record check with the Royal Canadian Mounted Police (RCMP) is required to process
your personnel security screening request with the Government of Canada. To complete this
check, visit an RCMP-accredited third-party fingerprint service provider and have your
fingerprints taken electronically and submitted to the RCMP. Please bring this form with
you and ask the officer conducting your fingerprint check to complete the below
portion of the form. Please request this officer to forward your fingerprint results
electronically to this Originating Agency Identifier (ORI) number:
Contract Security Program, Public Services and Procurement Canada:
ORI number PQ80800
To: Accredited third-party fingerprint service provider
Please assist the applicant in filling this form. The applicant is required to include their
document control number (DCN) on their personnel security screening application form. This
allows the Contract Security Program to continue processing their personnel security
screening request. Without this number, the program will be unable to match the incoming
criminal record check results from the RCMP, with their application, delaying the applicant’s
request. Please ensure the DCN is accurate.
Applicant name: ___________________________________________________________
Name of applicant’s organization (legal name): __________________________________
Fingerprint service provider (legal name): __________________________________
Name of officer conducting fingerprint check: __________________________________
Date: ____________________________________________________________________
The applicant must be provided with the 20-digit DCN.
Document control number (DCN). Please write carefully and clearly.
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General enquiries
Telephone: 1-866-368-4646 or 613-948-4176 (Monday to Friday, 8 am to 5 pm eastern
Version 1.0


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