Fingerprint Processing Application Form - Commonwealth Of Virginia

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COMMONWEALTH OF VIRGINIA
Status Hotline
Department of Criminal Justice Services
(804) 786-1132
P.O. Box 1300 • Richmond, VA 23218
1-877-9STATUS
Phone: (804) 786-4700 • Fax: (804) 786-6344
FINGERPRINT PROCESSING APPLICATION – FEE $50.00
IMPORTANT INFORMATION
To ensure a timely processing of a criminal history records check, the following must be submitted:
 A Fingerprint Application, fingerprint card, and $50.00 non-refundable fee.
 Please DO NOT bend, fold or hole-punch the fingerprint card and ensure that ALL vital information is filled out
completely on the fingerprint card prior to submittal.
 This Criminal History records check is only valid for 90 days from date of submittal. If applying for a credential under
the regulation of the Virginia Department of Criminal Justice Services (DCJS), please ensure application is submitted
within 90 days.
Applicant Information
SSN or DCJS ID:
Last Name:
First Name:
MI:
Mailing Address (Street/Apt.#):
City, State, Zip:
Physical Address (if different than mailing address):
City, State, Zip:
Email Address:
(
)
(
)
(
)
Home Phone:
Business Phone:
Fax:
11-
Employer Business Name:
DCJS ID:
Reason for Fingerprinting
Private Security Services
Special Conservator of the Peace
Bail Bondsmen
Virginia Code §§9.1-138-9.1-150
(SCOP)
Virginia Code §9.1-185 (et seq.)
Virginia Code §§9.1-150.1-9.1-150.4
Business License
Property or Surety License
SCOP Registration
Training School Certification
Bail Enforcement Agent
Individual Registration
Virginia Code §9.1-186 (et seq.)
Compliance Agent Certification
Instructor Certification
Bail Enforcement Agent License
Criminal History Records Check
Have you ever been convicted or found guilty of a felony or misdemeanor (not to include minor traffic violations) in
Virginia or any other jurisdiction to include military court martial or are you currently under protective orders?
No
Yes*
*If Yes, please attach a
Criminal History Supplemental Form
and criminal history documentation.
This form may be found on our website at
Attach Legal Presence Documentation to this Application
Legal documentation may be a copy of a birth certificate, US passport, INS Forms (N550, N560, N561, N570).
A full list of acceptable documentation may be found on the DCJS website at
10/2012
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