Skip to content
Home
Forms
About
Services
Live Scan Fingerprinting
DNA Testing
Drug Testing
Schedule Appointment
Home
Forms
About
Services
Live Scan Fingerprinting
DNA Testing
Drug Testing
Schedule Appointment
Contact Us
Home
Forms
About
Services
Live Scan Fingerprinting
DNA Testing
Drug Testing
Schedule Appointment
Contact Us
Home
Forms
About
Services
Live Scan Fingerprinting
DNA Testing
Drug Testing
Schedule Appointment
Contact Us
CALIFORNIA STATE BAR FINGERPRINTING FORM
A0281
ORI (Code assigned by DOJ)
License/Certification/Permit
Type of Application:
Job Title or Type of License, Certification or Permit:
TEACHER CRED 44340 EC
Agency Address Set Contributing Agency:
CASM TEACHER CREDENTIALING
Agency authorized to receive criminal history information
03294
Mail Code (five-digit code assigned by DOJ)
1900 Capitol Avenue
Street No. Street or PO Box
Contact Name (Mandatory for all school submissions)
Sacramento
City
CA
State
95811-4213
Zip Code
Contact Telephone No.
Name of Applicant: (Please print)
Last Name
First Name
MI
Alias:
Last Name
First Name
Driver’s License No:
Date of Birth
Sex
Male
Female
Misc. No. BIL -
Height
Weight
Eye Color
Hair Color
APPLICANT MUST PAY AT LIVE SCAN SITE:
Agency Billing Number
Place of Birth (State or Country)
Social Security Number
Misc Number
Other Identification Number
Home Address
Street Address or P.O. Box
City
State
Zipcode
Social Security Number (full):
Your Number:
OCA Number (Agency Identifying Number / CAL BAR#)
Level of Service:
DOJ
FBI
If re-submission, list original ATI number:(Must provide proof of rejection)
Original ATI Number
SUPPLEMENTAL AGENCY/EMPLOYER (County Office of Education/School District):
Employer Name
Street No.
Street or PO Box
Mail Code (COE/SD five digit code assigned by DOJ)
City
State
Zip Code
Agency Telephone No. (optional)
Live Scan Transaction Completed By:
Name of Operator
LSID
Date
Transmitting Agency
ATI No.
Amount Collected/Billed
Call for fees
SUBMIT
Scroll to Top
