New York State
Department of State
Division of Licensing Services
P.O. Box 22052
Albany, NY 12201-2052
Customer Service: (518) 474-7569
Employee Statement and Security Guard Application
ALL instructions carefully before completing the
application. Incomplete forms will be returned. Any omission,
inaccuracy or failure to make full disclosure may be deemed
sufficient reason to deny a registration or may result in the
suspension or revocation of an issued registration.
FINGERPRINT REQUIREMENTS: Applicants have access
to electronic fingerprinting through IdentoGo by IDEMIA.
Electronic Fingerprinting Procedure:
Schedule Appointment: Applicants must schedule
appointments with IdentoGo by IDEMIA. To schedule an
appointment at a location near you, visit their website at
www.identogo.com or call 877-472-6915. For scheduling
purposes, you must utilize the required Service Code 1545R1.
Failure to use the correct license type or Service Code may
result in the need to be reprinted.
What to bring to Appointment: Approved and
acceptable form of identification (for a list, please visit
with an acceptable form of payment.
Proof of electronic fingerprint completion: Upon
completion of the fingerprint process, the vendor will
provide you with two receipts as proof of fingerprint
completion. Include one receipt with your application.
The second copy of the receipt should be retained by
Please Note: Fingerprint receipts are valid for 5 months
from the date of fingerprinting. Please submit original
application within 5 months from the date of fingerprinting.
Failure to submit your application within this time period
will require you to complete the fingerprint process again.
All fees for fingerprinting are payable to IDEMIA.
● Division of Criminal Justice Services (DCJS) fee: $75.00
● FBI fee (Security Guard License applicants must pay
the FBI fee): $13.25.
● Applicable Fingerprint Vendor fee (subject to change in
January and July of each year)
See “e-Fingerprinting” link on top right at:
Acceptable forms of Payment:
Payment for fingerprint fees must be made in the form of
check, money order or credit card payable to IDEMIA.
Note: Fingerprinting fees are in addition to application fees.
Please read the below FBI Application Notifications:
● Fingerprints submitted will be used to check the criminal
history records of the FBI.
● Procedures for obtaining a copy of an FBI criminal
history record are set forth at Title 28, Code of Federal
Regulations (CFR), Sections 16.30 through 16.33 or go
to the FBI website at http://www.fbi.gov/about-
● Procedures for obtaining a change, correction or
updating an FBI criminal history record are set forth at
Title 28, Code of Federal Regulations (CFR), Section
Child Support Statement
A Child Support Statement is mandatory in New York
State (General Obligations Law) regardless of whether
or not you have children or any support obligation. Any
person who is four months or more in arrears in
child support may be subject to having his or her
business, professional and driver’s licenses
suspended. The intentional submission of a false
written statement for the purpose of frustrating or
defeating the lawful enforcement of support obligations
is punishable under §175.35 of the Penal Law. It is a
Class E felony to offer a false instrument for filing with a
state or local government with the intent to defraud.
SOCIAL SECURITY NUMBERS (PRIVACY
The Department of State is required to collect the federal
Social Security and Employer Identification numbers of all
licensees. The authority to request and maintain such
personal information is found in §5 of the Tax Law and §3-503
of the General Obligations Law. Disclosure by you is
mandatory. The information is collected to enable the
Department of Taxation and Finance to identify individuals,
businesses and others who have been delinquent in filing tax
returns or may have underestimated their tax liabilities and to
generally identify persons affected by the taxes administered
by the Commissioner of Taxation and Finance. It will be used
for tax administration purposes and any other purpose
authorized by the Tax Law and may also be used by child
support enforcement agencies or their authorized
representatives of this or other states established pursuant to
Title IV-D of the Social Security Act, to establish, modify or
enforce an order of support, but will not be available to the
public. A written explanation is required where no number is
provided. This information will be maintained in the Licensing
Information System by the Director of Administration and
Management at One Commerce Plaza, 99 Washington
Avenue, Albany, NY 12231-0001.
Section 89H of Article 7A requires that you notify this division
of any changes to your residence address so you can receive
renewal notices and other notifications pursuant to your
DOS-1206-f-a (Rev. 05/20)
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WOULD YOU LIKE TO REGISTER TO VOTE?
Please visit the NY State Board of Elections at www.elections.ny.gov/votingregister.html
or call 1-800-FOR-VOTE to request a NYS Voter Registration form.
lease visit www.n