Form 41 Ls - Job title or type of license, certification or permit: Agency authorized to receive criminal history information. Required fields agency address set contributing agency: Job title or type of license, certification or permit: Web applicant to enter home address, which is mandatory on the ctc form and for applicants requiring a child abuse index check and where statute requires a notification to the applicant as well as the agency. Web request for live scan service. This information must appear exactly as shown for acceptance by the doj and fbi. If it does not prepopulate when downloaded, please ensure that the information provided below is included prior to submission. Applicant must contact their contributing agency to verify the accuracy of the form required for their live scan submission.
Job title or type of license, certification or permit: Web applicant to enter home address, which is mandatory on the ctc form and for applicants requiring a child abuse index check and where statute requires a notification to the applicant as well as the agency. Applicant must contact their contributing agency to verify the accuracy of the form required for their live scan submission. This information must appear exactly as shown for acceptance by the doj and fbi. Required fields agency address set contributing agency: Web request for live scan service. Job title or type of license, certification or permit: Agency authorized to receive criminal history information. If it does not prepopulate when downloaded, please ensure that the information provided below is included prior to submission.