INSTRUCTIONS FOR LIVE SCAN

Step 1: Download the LiveScan form using the button above and fill out the form. The top portion is pre-filled with agency information. You only need to fill out the middle portion for “Applicant Information” (highlighted and numbered below):

Numerical Guide For Filling Out the Form:

[1] Legal Last Name

[2] Legal First Name

[3] Middle Name Initial (if none, leave blank)

[4] Legal Name Suffix (if none, leave blank)

[5] Date of Birth

[6] (Check One): Male or Female

[7] Driver’s License Number

[8] Height

[9] Weight

[10] Eye Color

[11] Hair Color

[12] State or County of Birth

[13] Social Security Number (If none, leave blank)

[14] Home Address First Line (House Number and Street Name)

[15] Home Address City

[16] Home Address State

[17] Home Address Zip Code

[18] Sign Here

[19] Date of signature

Step 2: Take this completed form to a local LiveScan Fingerprint Rolling Agency. Use this website to find the nearest LiveScan location near you. There are also mobile LiveScan services: https://oag.ca.gov/fingerprints/locations

Step 3: The LiveScan Fingerprint Rolling Agency will fill out the bottom portion and return the form back to you.

Step 4: Upload this completed from to your pending job application in SMARTCare.