Fillable Form Application Instructions for: ACCURATE BIOMETRICS FBI Personal

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Form Application Instructions for: ACCURATE BIOMETRICS FBI Personal

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Rev. 05/07/21
ACCURATE BIOMETRICS
Form Application Instructions for
FBI Personal Background Check Service
(also known as Departmental Order 556-73 or Identity History Summary – IdHS)
Please follow these instructions for filling out your application forms. Incorrectly filled out
applications may delay the processing of your request.
Follow these simple steps to get your FBI Background Check/ Rap Sheet Report:
Step 1: Complete the applicant information form
● IMPORTANT: Please do not alter your Applicant Information Form. This may cause a delay
in processing. If you have special instructions for Accurate Biometrics, you may mention
those instructions in a cover letter.
● Please read the form carefully and be sure to include all the required information. The Social
Security Number (SSN) field is optional. If you include it, the last 4-digits of your SSN will
appear in your report.
● FBI responses must be returned to the applicant’s address or to the applicant’s attorney. If
the results are to be sent to an attorney, a letter of release on the attorney’s letterhead must
be included with your application; you will need to sign the letter along with the attorney.
● All applicants will have 1-time access to results at our secure web portal. Additional options
are available for delivery of an additional hard copy print of the rap sheet report.
○ OPTION #1, $50 – Web Portal Service
Rap Sheet available securely online.
○ OPTION #2, $60 - Web Portal and USPS Mail Service
Rap Sheet available securely online and also mailed out via USPS First Class mail.
○ OPTION #3, $75 - Web Portal and Priority 2-Day service – Domestic (U.S.)
Rap Sheet available securely online and delivered to a valid US address via Priority
2-Day service within 24 hours of processing, during normal business hours.
Step 2: Obtain two sets of your fingerprints
● Print two of the standard FBI FD-258 fingerprint card form provided in the forms packet. It is
acceptable to print the FD-258 form on standard white printer/copy paper. Please use black
ink when filling out the form.
● You will need to submit two completed original FBI FD-258 fingerprint forms or cards. Photo
copies of the completed FBI fingerprint form are not acceptable.
Note: The two fingerprint cards should be from two different fingerprinting attempts. The
cards are compared to see which is of better quality. This helps lessen to the chance of a
rejection from the FBI.
Important Applicant Note: All applicants must use the standard FBI FD-258 fingerprint card
form; do not submit fingerprints on non-FBI fingerprint card forms.
● Your name, date of birth, and signature must be provided on each fingerprint card.
Fingerprints should be placed on the standard FBI FD-258 fingerprint form or card.
Note: Information on the application should match the information on the applicant fingerprint
form. If there is a discrepancy, information from the applicant form will be used to generate
your report.
● Individuals may NOT fingerprint themselves; fingerprints MUST be obtained from a law
enforcement or other authorized fingerprinting contractor.
● Include two sets of rolled impressions of all 10 fingerprints and impressions of all 10
fingerprints taken simultaneously (these are sometimes referred to as plain or flat
impressions). All fingerprint boxes must be filled in, or exceptions must be noted.
● Note: We will also accept fingerprint cards created by printing on to the cards from an
electronic capture by an authorized fingerprint provider such as a local law enforcement
agency or licensed fingerprint contractor. (Still a physical card, not an electronic
transmission).
● IMPORTANT: Include your complete email address in case there are any questions that
could delay processing of your prints. A receipt email is available upon request. The Mailing
Checklist included will help make sure you have everything.
Step 3: Review Rap Sheet report pick up and shipping options
Online Portal Pick-Up
All applicants will have 1-time access to results at our secure web portal. Please note that your report
will not be accessible on mobile phones, tablets or ipads. The report is only accessible on a personal
computer using Adobe Reader. Those without access to a computer, should consider selecting one
of the mail options.
● Options #2 and #3 include delivery of an additional hard copy print of the rap sheet report.
The only difference is the mail service.
○ OPTION #2, $60 - Web Portal and USPS Mail Service
Rap Sheet available securely online and also mailed out via USPS First Class mail.
○ OPTION #3, $75 - Web Portal and Priority 2-Day service – Domestic (U.S.)
Rap Sheet available securely online and delivered to a valid US address via Priority
2-Day service within 24 hours of processing, during normal business hours.
● For those who wish a printed copy to be mailed to you, please note that the costs above
include the fee charged directly by the FBI, and all shipping and handling charges.
● The FBI Rap Sheet report is sent to you from Accurate Biometrics. If you choose to have
your report sent via mail or expedited service, it will be printed and sent to you on white
secure watermark paper.
Additional copies of your FBI Rap Sheet - $10
● Note: If an extra copy of your FBI Rap Sheet is requested to be delivered via UPS or USPS,
that copy will be printed in color on white secure paper featuring a watermark of the FBI seal
in the background and the signature of the FBI Section Chief.
Step 4: Submit payment
● Option 1: Obtain a money order or cashier’s check for the fee based on desired service in
U.S. dollars made payable to Accurate Biometrics. Please be sure to sign where required.
● Option 2: Pay by credit card using the Credit Card Payment Form. Don’t forget to include
the expiration date and three digit security code of the credit card that you are using.
● Important notes:
○ Cash or personal checks will not be accepted for mail in service.
○ Payment must be for the exact amount.
○ If the request is for a couple, family, etc., include the total fee for each person. The
payment may be processed as one credit card transaction.
○ View our convenient payment options.
Step 5: Mail the required items to the following address
Accurate Biometrics – Departmental Order
500 Park Blvd, Suite 1260
Itasca, IL 60143
Review Required Items
Please review the checklist included in the forms packet to make sure you include everything or your
departmental order processing may be delayed.
Your mailing must include:
● Signed applicant information form
● Two original fingerprint cards
● Appropriate payment in U.S. dollars for each person or copy requested
● Please include checklist form
Important Notes
● Include your complete email address in case there are any questions that could delay
processing of your prints.
● Payment receipt available upon written request submitted with application.
● Fingerprints are submitted real-time with results delivered often within minutes of
submission. Once fingerprints have been submitted NO REFUND REQUESTS CAN BE
GRANTED.
● Accurate Biometrics, a certified FBI Channeler, is required to print the criminal history
response exactly as it is electronically received from the CJIS Division of the FBI.
This is
in accordance with the FBI issued “Channeler Requirements for the Departmental Order
Process,” dated June 10, 2011.
● Federal Bureau of Investigation Notification: Channelers can only process Departmental
Orders for US Citizens and Non-US Citizens who have permanent resident status; Non-US
Citizens without permanent residence status must make the Departmental Order request
directly to the FBI.
● Inquiries for Departmental Orders must be made by the individual applicant and the FBI
response must be sent to the applicant or the applicant’s attorney. If the FBI Rap Sheet is
sent to an attorney, a letter of release must be signed by both the applicant and attorney on
the attorney's letterhead.
● Access to one’s rap sheet or FBI report to challenge, update or correct information is
pursuant to Title 28 CFR Part 16.30 to 16.34.
● Accurate Biometrics, a certified FBI Channeler, is approved to electronically process FBI
fingerprint background check requests in accordance with Department of Justice Order
556-73.
What happens if my fingerprints are rejected?
There is a possibility that your fingerprints will be successfully received by the FBI, but are unable to
be processed by the FBI. If this occurs, you will receive a reprint notification to the email address you
provided requesting another set of fingerprints to complete the transaction.
There are a small percentage of individuals in which the fingerprint image quality is very low. An
individual, by the nature of their work or age, may have very thin or worn ridges in the pattern area.
You may submit multiple sets of fingerprints taken by a fingerprint technician or law enforcement
agency. You may send additional fingerprint cards (FBI form FD 258) to Accurate Biometrics with a
newly completed copy of the applicant information form, along with a copy of the rejection letter, and
a money order or credit card form for $10.00.
Note: If a third submission is required, the full processing fee must be submitted with the required
forms and fingerprints.
To assist you in learning more about taking legible fingerprints, refer to the following site:
https://www.fbi.gov/services/cjis/fingerprints-and-other-biometrics/recording-legible-fingerprints
What comes back in the FBI Report Rap Sheet?
The FBI Report Rap Sheet is returned containing the following:
● FBI letterhead format in full color
● FBI Seal in full color
● Signature of presiding FBI CJIS Section Chief, Biometric Service Section
● FBI Transaction Control Number (TCN)
● Date search was completed
● Applicant name exactly as stated on the request form
● Applicant address if included on the request form
● SSN if included on the request form
● All Identity History Summary (IdHS) record information reported to the FBI when the
background check was processed
For additional assistance, please call our Customer Service Team at (866) 361-9944 or email us at
info@accuratebiometrics.com.
Thank you. We appreciate the opportunity to serve you.
(Rev 09/19/2018)
APPLICANT INFORMATION FORM
PRIVACY ACT STATEMENT: The FBI’s acquisition, retention, and sharing of information submitted on this form is generally authorized under 28 USC 534 and
28 CFR 16.30-16.34. The purpose for requesting this information from you is to provide the FBI with a minimum of identifying data to permit an accurate and timely
search of identity history identification records. Providing this information (including your Social Security Account Number) is voluntary; however, failure to
provide the information may affect the completion of your request. The information reported on this form may be disclosed pursuant to your consent and may also be
disclosed by the FBI without your consent pursuant to the Privacy Act of 1974 and all applicable routine uses. Under the Paperwork Reduction Act, you are not
required to complete this form unless it contains a valid OMB control number. The form takes three minutes to complete.
Applicant Information * Indicates Required Fields
* Last Name *Sex *Race
* First Name *Height: *Eye Color:
Middle Name *Weight: *Hair Color:
* Date of Birth *Place of Birth (State or Country if outside US):
* Phone Number
* Address: *City/St/Zip
Social Security Number (SSN):
Note: The SSN on line above is voluntary. Enter it only if you want the last 4 digits of your SSN to appear on your FBI response.
* Email Address:
Note: We will use your email address to send you a link to pick your FBI Report response on our secure web portal.
*Please indicate preferred method of sending your FBI report to you: (Choose just one option)
Option 1 – Web Portal pick up – Quick response time. FBI report access – a one-time digital download from the Accurate
Biometrics Customer Website. This service allows the applicant to retrieve/save/print their individual FBI response, usually within
24 hours, after fingerprints are either processed using live scan (electronic capture) or card scan through our office if FBI FD-258
card(s) are submitted. You will get an email from us once your response has been returned to us from the FBI. Online access to the
FBI response report is available online for 30 days via your computer following the email notice to the applicant. Once the report is
accessed or 30 days (whichever is shorter), the record is deleted.
Option 2* – Includes Option 1 plus US Mail (First Class) to U.S. addresses only. Must complete address segment below.
Number of additional copies requested. Additional copies are $10 each and will be added to your total processing charge.
Option 3* – Includes Option 1 plus 2-Day Priority Service to U.S. addresses only. Must complete the address area below.
Number of additional copies requested. Additional copies are $10 each and will be added to your total processing charge.
“Mail Results To” address – The name must be the name of the applicant indicated above or the applicant’s attorney (no third
parties or “in care of” addressees). If response is being sent to the applicant’s attorney, the attorney must include a letter of release
statement on the attorney’s letterhead and INCLUDE SIGNATURES of BOTH the APPLICANT and the ATTORNEY.
*Applicant Name
Applicant’s Attorney Name (if applicable)
*Address (No PO boxes, No “In Care Of” or Third Parties) Required only for mailing. It will not appear on the response form.
________________________________________________________________________________________________
*City *State *Zip Code
*Payment
CASHIER’S CHECK / MONEY ORDER CREDIT CARD (if by mail, please submit credit card form, available on our website.
*Reason for Request:
To Review your own record
To adopt a child
To live, work, or travel in a foreign country
To challenge information on your record
Other Court-Related Matters. Please explain________________________________________________________________
*APPLICANT SIGNATURE ________________________________________________ DATE_______________
AccurateBiometrics.com Main Office: 500 Park Boulevard, Ste. 1260, Itasca, IL 60143 Contact: info@accuratebiometrics.com
*U.S. Citizen or Legal Permanent Resident Yes No If no, you must submit your request directly to the FBI
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MAILING CHECKLIST
Requirements for FBI Criminal Report Requests
To expedite your ngerprint submission, please ll in your contact information below so that we can reach you
in case there are any problems or discrepancies with your application. If we don’t have the required form(s)
correctly lled out, we cannot process your prints. Call our Customer Service Team at 866-361-9944 or email
us at info@accuratebiometrics.com if you have any questions.
Applicant Full Name
Best Phone Number / Time to Reach You
Best Email Address to Reach You
Referred By
Please complete the checklist below:
c I have completed the FBI Application Information Form with all the required elds lled in
accurately and completely. Make sure to choose a reason for ngerprinting option; if “Other” is
chosen, write in the reason on the blank line provided (we cannot process “for employment” or
“licensing within the U.S.”) Don’t forget to sign and date the form, and include email address.
c For attorney requests, I have included a signed Attorney Release form printed on my attorney’s
letterhead with signatures from both the applicant and the attorney.
c I have included 2 original ngerprint cards or electronically produced ink cards from an authorized
ngerprint provider (local law enforcement agency or licensed ngerprint vendor)
c I have included payment. Currently accepted forms of payment include:
• All Major Credit Cards and Debit Cards (double check that this information is correct)
• Money Order
• Please make the following payable to: Accurate Biometrics
– Cashier’s Check
– Company/Agency Check
– Pre-approved Billing Terms
• Cash or personal checks are not accepted
c I have double checked all information for accuracy and am including this Mailing Checklist to
provide my contact information to help speed processing:
MAIL TO: (at envelope preferred)
Accurate Biometrics
Attn: Departmental Order
500 Park Boulevard, Suite 1260
Itasca, IL 60143
PLEASE PRINT CLEARLY
IF APPLICABLE, PLEASE LIST THE REFERRING COMPANY OR ORGANIZATION AND CONTACT INFORMATION
(Rev. 09/26/2019)
PAYMENT INFORMATION
Credit Card Payment Form
* Denotes Required Fields
(if applicable)
Applicant
* Full Name
Company Name
* Billing Address
Billing Address 2
* City * State/Province
* Postal (ZIP) Code * Country
Type of Credit Card:  Visa  Mastercard  American Express  Discover
Credit Card Number
Name on Credit Card
Expiration Date CVV Code Billed to Credit Card
Phone Number
(including area code)
Email Address
I understand and agree to the cardholder agreement and by doing so, give Accurate Biometrics the
permission to charge the above credit card for the amount listed.
Card Holder Signature
Date
Total Amount to be
(click to select card type)
PRINT
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signature
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Instructions for completing the personal information on the fingerprint forms:!
All fields highlighted in yellow above must be filled out on the fingerprint form completely.
Be sure to fill out both forms. Please print legibly and use BLACK INK.
1. Please print clearly in the First, Middle and Last Name fields.
2. Signature of P
erson Being Fingerprinted – You must sign this section when your fingerprints are
applied to the card/form. This signature should be your full legal name, and it must be signed in the
presence of the agent taking your fingerprints, so DO NOT sign the card before your
fingerprinting visit.
3. Residence of Person Fingerprinted – Enter the residence of the person being fingerprinted.
4. Signature of Official and Date – Card must be signed and dated by the agent taking your prints.
5. Reason Fingerprinted – Please fill in the reason for fingerprinting in this field.
6. Date of Birth – Date of Birth should be entered MM/DD/YYYY.
7. Citizenship – Please enter the country of your citizenship.
8. Sex – Use M for Male and F for Female.
9. Race – Use the following for race.
W – White#
I – American Indian or Alaskan Native
H – Hispanic A – Asian
B – Black
10. HGT (Height) – Enter height in feet and inches-- for example 5’5”.
11. WGT (Weight) – Enter weight in pounds – for example 140.
12. Eyes – Use the following abbreviations for Eye Color:
BLK – Black GRN – Green
BLU – Blue GRY – Gray
BRO – Brown HZL – Hazel
13. Hair – Use the following abbreviations for Hair Color:
BLK – Black GRY – Grey/partially grey
RED – Red BLN – Blonde
WHI – White BLD – Bald
BRO – Brown
14. Place of Birth (POB) – Enter the US state or the country of birth if place of birth is out of the US.
15. Social Security Number (SOC) – Enter the social security number of the person being fingerprinted.
Questions? Call 1-866-361-9944 or send us an
Email at info@accuratebiometrics.com
Note: It is acceptable for a copy of the
FBI FD-258 fingerprint card in this pdf to
be printed on standard white letter-sized
printer paper for ink card processing.
SEX CODE TABLE
External Code
Literal
F
Female
M Male Male
X Unknown Unknown Sex
EYE COLOR CODE TABLE
Eye Color Literal
External Code
BLACK
BLK
BLUE
BLU
BROWN
BRO
GRAY
GRY
GREEN
GRN
HAZEL
HAZ
MAROON
MAR
MULTICOLOR MUL
PINK PNK
HAIR CODE TABLE
BALD
BLD
BLACK
BLK
BLONDE (or strawberry)
BLN
BLUE
BLU
BROWN
BRO
GREEN
GRN
GRAY (or partially gray)
GRY
ORANGE
ONG
PURPLE
PLE
PINK
PNK
RED (or auburn)
RED
SANDY
SDY
WHITE
WHI
UNKNOWN
XXX
RACE CODE TABLE
External Code
Literal
Description (If Subject Is)
A
Asian or
Pacific Islander
Chinese, Japanese, Filipino,
Korean, Polynesian, Indian,
Indonesian, Asian Indian,
Samoan, or other Pacific
Islander
B
Black
A person having origins in any
of the black racial groups of
Africa
I
American Indian
or Alaskan Native
American Indian, Eskimo, or
Alaskan Native, or a person
having origins in any of the 48
contiguous states of the United
States or Alaska who maintains
cultural identification through
tribal affiliation or community
recognition
U
Unknown
Of Indeterminable Race
W
White
Caucasian, Mexican, Puerto
Rican, Cuban, Central or South
American, or other Spanish
culture or origin, regardless of
race.
FD-258 (REV.12-10-07)
LEAVE BLANK
APPLICANT
TYPE OR PRINT ALL INFORMATION IN BLACK FBI LEAVE BLANK
LAST NAME FIRST NAME MIDDLE NAME
NAM
ALIASES
AKA
DATE OF BIRTH
DOB
Month Day Year
PLACE OF BIRTH
POB
SEX RACE HGT. WGT. EYES HAIR
LEAVE BLANK
CITIZENSHIP
CTZ
YOUR NO.
OCA
O
R
I
CLASS
REF.
FBI NO.
FBI
ARMED FORCES NO.
MNU
SOCIAL SECURITY NO.
SOC
MISCELLANEOUS NO.
MNU
SIGNATURE OF PERSON FINGERPRINTED
RESIDENCE OF PERSON FINGERPRINTED
DATE
EMPLOYER AND ADDRESS
REASON FINGERPRINTED
SIGNATURE OF OFFICIAL TAKING FINGERPRINTS
1. R. THUMB 2. R. INDEX 3. R. MIDDLE 4. R. RING 5. R. LITTLE
6. L. THUMB 7. L. INDEX 8. L. MIDDLE 9. L. RING 10. L. LITTLE
L. THUMB R. THUMB RIGHT FOUR FINGERS TAKEN SIMULTANEOUSLYLEFT FOUR FINGERS TAKEN SIMULTANEOUSLY
* See Privacy Act Notice on Back
FD-258 (REV.12-10-07)
LEAVE BLANK
APPLICANT
TYPE OR PRINT ALL INFORMATION IN BLACK FBI LEAVE BLANK
LAST NAME FIRST NAME MIDDLE NAME
NAM
ALIASES
AKA
DATE OF BIRTH
DOB
Month Day Year
PLACE OF BIRTH
POB
SEX RACE HGT. WGT. EYES HAIR
LEAVE BLANK
CITIZENSHIP
CTZ
YOUR NO.
OCA
O
R
I
CLASS
REF.
FBI NO.
FBI
ARMED FORCES NO.
MNU
SOCIAL SECURITY NO.
SOC
MISCELLANEOUS NO.
MNU
SIGNATURE OF PERSON FINGERPRINTED
RESIDENCE OF PERSON FINGERPRINTED
DATE
EMPLOYER AND ADDRESS
REASON FINGERPRINTED
SIGNATURE OF OFFICIAL TAKING FINGERPRINTS
1. R. THUMB 2. R. INDEX 3. R. MIDDLE 4. R. RING 5. R. LITTLE
6. L. THUMB 7. L. INDEX 8. L. MIDDLE 9. L. RING 10. L. LITTLE
L. THUMB R. THUMB RIGHT FOUR FINGERS TAKEN SIMULTANEOUSLYLEFT FOUR FINGERS TAKEN SIMULTANEOUSLY
* See Privacy Act Notice on Back
This page for information only -- FBI Privacy Statement
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Form Application Instructions for: ACCURATE BIOMETRICS FBI Personal

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Completed 27 January 2022

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