Form Dos-1206-F-A - Employee Statement And Security Guard Application Page 3
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5Employee Statement and Security Guard Application
INSTRUCTIONS
Read ALL instructions carefully before completing the application. Incomplete forms will be returned. Any omission, inaccuracy or
failure to make full disclosure may be deemed sufficient reason to deny a registration or may result in the suspension or revocation of
an issued registration.
FINGERPRINT REQUIREMENTS:
Applicants have access to electronic fingerprinting through IdentoGo by MorphoTrust USA.
Electronic Fingerprinting Procedure:
Schedule Appointment: Applicants must schedule appointments with IdentoGo by MorphoTrust USA. To schedule an appointment at a
location near you, visit their website at or call 877-472-6915. For scheduling purposes, you must utilize the required
ORI number SecGuard.
What to bring to Appointment: Complete the Request for NYS Fingerprinting Services – Information Form (pdf) and BRING IT
with you to the fingerprinting site.
Proof of electronic fingerprint completion: Upon completion of the fingerprint process, the vendor will provide you with two
receipts as proof of fingerprint completion. Include one receipt with your application. The second copy of the receipt should be
retained by your employer.
Please Note: Fingerprint receipts are valid for 5 months from the date of fingerprinting . Please submit original application within 5
months from the date of fingerprinting. Failure to submit your application within this time period will require you to complete the
fingerprint process again.
Fingerprint Fees:
All fees for fingerprinting are payable to MorphoTrust USA.
● Division of Criminal Justice Services (DCJS) fee: $75.00
● FBI fee (Security Guard License applicants must pay the FBI fee): $12.00
● Applicable Fingerprint Vendor fee (subject to change in January and July of each year)
See “e-Fingerprinting” link on top right at
Acceptable forms of Payment:
Payment for fingerprint fees must be made in the form of check, money order or credit card payable to MorphoTrust USA.
Note: Fingerprinting fees are in addition to application fees.
Please read the below FBI Application Notifications:
● Fingerprints submitted will be used to check the criminal history records of the FBI.
● Procedures for obtaining a copy of an FBI criminal history record are set forth at Title 28, Code of Federal Regulations (CFR),
Sections 16.30 through 16.33 or go to the FBI website at
● Procedures for obtaining a change, correction or updating an FBI criminal history record are set forth at Title 28, Code of Federal
Regulations (CFR), Section 16.34
Child Support Statement
A Child Support Statement is mandatory in New York State (General Obligations Law) regardless of whether or not you
have children or any support obligation. Any person who is four months or more in arrears in child support may be
subject to having his or her business, professional and driver’s licenses suspended. The intentional submission of
a false written statement for the purpose of frustrating or defeating the lawful enforcement of support obligations is
punishable under §175.35 of the Penal Law. It is a Class E felony to offer a false instrument for filing with a state or local
government with the intent to defraud.
SOCIAL SECURITY NUMBERS (PRIVACY NOTIFCATION):
The Department of State is required to collect the federal Social Security and Employer Identification numbers of all licensees. The
authority to request and maintain such personal information is found in §5 of the Tax Law and §3-503 of the General Obligations Law.
Disclosure by you is mandatory. The information is collected to enable the Department of Taxation and Finance to identify individuals,
businesses and others who have been delinquent in filing tax returns or may have underestimated their tax liabilities and to generally
identify persons affected by the taxes administered by the Commissioner of Taxation and Finance. It will be used for tax administration
purposes and any other purpose authorized by the Tax Law and may also be used by child support enforcement agencies or their
authorized representatives of this or other states established pursuant to Title IV-D of the Social Security Act, to establish, modify or
enforce an order of support, but will not be available to the public. A written explanation is required where no number is provided. This
information will be maintained in the Licensing Information System by the Director of Administration and Management at One
Commerce Plaza, 99 Washington Avenue, Albany, NY 12231-0001.
Section 89H of Article 7A requires that you notify this division of any changes to your residence address so you can receive renewal
notices and other notifications pursuant to your registration.
DOS-1206-f-a (Rev. 09/16)
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