Form HCD OL8016 CP "Request for Live Scan Service - Course Provider" - California

What Is Form HCD OL8016 CP?

This is a legal form that was released by the California Department of Housing & Community Development - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2005;
  • The latest edition provided by the California Department of Housing & Community Development;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a printable version of Form HCD OL8016 CP by clicking the link below or browse more documents and templates provided by the California Department of Housing & Community Development.

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Download Form HCD OL8016 CP "Request for Live Scan Service - Course Provider" - California

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REQUEST FOR LIVE SCAN SERVICE
Applicant Submission
ORI:
A0040
Type of Application:
LICENSE CERT OR PERMIT
Code assigned by DOJ
Job Title or Type of License, Certification or Permit:
Course Provider
SEE BACKSIDE FOR LIST OF APPLICABLE HCD APPLICATION TYPES
Agency Address Set Contributing Agency:
_Calif. Dept. of Housing & Community Development
01059
Agency authorized to receive criminal history information
Mail Code (five digit code assigned by DOJ)
P.O. BOX 31
Occupational Licensing Staff
Street No.
Street or P.O. Box
Contact Name (Mandatory for all school submissions)
Sacramento
CA 95812-0031
(_916_) _323-9803
City
State
Zip Code
Contact Telephone No.
Name of Applicant:
(Please print)
Last
First
MI
Alias:
Driver’s License No.
Last
First
Date of Birth:
Sex
Male
Female
Misc. No. BIL -
100104
Agency Billing Number (if applicable)
Misc. No.:
Height:
Weight:
Eye Color:
Hair Color:
Home Address:
Street or P.O. Box
Place of Birth:
City
State
Zip Code
SSN:
Your Number:
NA
Level of Service
DOJ
FBI
OCA No. (Agency Identifying No.)
If resubmission, list Original ATI No.
Employer: (
)
Additional response for agencies specified by statute
NA
Employer Name
Street No.
Street or P.O. Box
Mail Code (five digit code assigned by DOJ)
(
)
City
State
Zip Code
A g en c y Te le ph on e No . (o p t ion a l)
Live Scan Transaction Completed By:
Date:
Name of Operator
Transmitting Agency
ATI No.
Amount Collected/Billed
NOTE: Illegible, incomplete, or incorrect information may result in processing delays or the denial of your application.
ORIGINAL - Live Scan Operator; SECOND COPY - HCD; THIRD COPY - Applicant
HCD OL 8016 (New 11/05)
REQUEST FOR LIVE SCAN SERVICE
Applicant Submission
ORI:
A0040
Type of Application:
LICENSE CERT OR PERMIT
Code assigned by DOJ
Job Title or Type of License, Certification or Permit:
Course Provider
SEE BACKSIDE FOR LIST OF APPLICABLE HCD APPLICATION TYPES
Agency Address Set Contributing Agency:
_Calif. Dept. of Housing & Community Development
01059
Agency authorized to receive criminal history information
Mail Code (five digit code assigned by DOJ)
P.O. BOX 31
Occupational Licensing Staff
Street No.
Street or P.O. Box
Contact Name (Mandatory for all school submissions)
Sacramento
CA 95812-0031
(_916_) _323-9803
City
State
Zip Code
Contact Telephone No.
Name of Applicant:
(Please print)
Last
First
MI
Alias:
Driver’s License No.
Last
First
Date of Birth:
Sex
Male
Female
Misc. No. BIL -
100104
Agency Billing Number (if applicable)
Misc. No.:
Height:
Weight:
Eye Color:
Hair Color:
Home Address:
Street or P.O. Box
Place of Birth:
City
State
Zip Code
SSN:
Your Number:
NA
Level of Service
DOJ
FBI
OCA No. (Agency Identifying No.)
If resubmission, list Original ATI No.
Employer: (
)
Additional response for agencies specified by statute
NA
Employer Name
Street No.
Street or P.O. Box
Mail Code (five digit code assigned by DOJ)
(
)
City
State
Zip Code
A g en c y Te le ph on e No . (o p t ion a l)
Live Scan Transaction Completed By:
Date:
Name of Operator
Transmitting Agency
ATI No.
Amount Collected/Billed
NOTE: Illegible, incomplete, or incorrect information may result in processing delays or the denial of your application.
ORIGINAL - Live Scan Operator; SECOND COPY - HCD; THIRD COPY - Applicant
HCD OL 8016 (New 11/05)