Fillable Ac.curate eiornetric.s UCIA www.accuratebiometrics.com (University of Illinois at Springfield)

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Ac.curate eiornetric.s UCIA www.accuratebiometrics.com (University of Illinois at Springfield)

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Ac.curate
eiornetric.s
Live
Scan
Fingerpr
i
nting
&
Ident
i
ty
Services
D
I I
Phone: 773-685-5699
Fax: 773-685-5433
www.accuratebiometrics.com
UCIA
Thank you for choosing Accurate Biometrics for your fingerprinting needs.
PLEASE PROVIDE THE FOLLOWING INFORMATION (PLEASE PRINT CLEARLY)
Last name:
First name:
Middle Initial: Daytime Phone:
Date of Birth:
Sex: (circle one) Male Female
(circle one)
Race: White Black Hispanic Asian American Indian/Alaskan Other
ORI-
REQUESTOR (UNIVERSITY) INFORMATION - ON FILE WITH THE ILLINOIS STATE POLICE
I, the undersigned, authorize Accurate Biometrics to capture and transmit my fingerprints and
above-noted demographic data to the Illinois State Police. I understand that the Illinois State
Police will return the results of the fingerprint search to the Requestor listed above.
Signature ___________________________________ Date ______________
(Do Not Write Below This Line—For Office Use Only)
F.P. Tech: ________________ TCN:
Date Fingerprinted:
University of Illinois-Springfield
ILL13703S
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Fingerprint/Background Check Process Instructions
Requirements:
• Valid government-issued photo ID.
• Completed personal information form provided by UIS.
• Money order, Cashier's Check, MasterCard/Visa. NO PERSONAL CHECKS OR CASH ACCEPTED.
• Fee: $30.00 (as of August 1, 2012). This fee includes all fees charged by the Illinois State Police.
• All applicants must be age 18 or over to be fingerprinted.
Accurate Biometrics in Springfield (As of August 1, 2019)
Sangamon Center North - 1885 Sangamon Avenue, Suite 140, Springfield, IL 62702
Schnucks’ Strip Mall near intersection of Peoria Rd & E. Sangamon Ave.
Monday and Wednesday - 9:00 am to 12:30 pm & 1:30 pm to 5:00 pm.
Fingerprinting does not need to be completed at the Springfield location. Please go to
http://www.accuratebiometrics.com and click on the map of Illinois to confirm testing dates and
times near you; there are offices throughout Illinois. Questions - call 866-361-9944 for Accurate
Biometrics Customer Service.
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Ac.curate eiornetric.s UCIA www.accuratebiometrics.com (University of Illinois at Springfield)

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Completed 24 July 2020

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