Rev. March 2020 Page 1 of 5
BUSINESS, CONSUMER SERVICES AND HOUSING AGENCY • GAVIN NEWSOM, GOVERNOR
DEPARTMENT OF CONSUMER AFFAIRS
BUREAU OF SECURITY AND INVESTIGATIVE SERVICES
P.O. Box 989002, West Sacramento, CA 95798-9002
P (916) 322-4000 | P (800) 952-5210 | F (916) 575-7290 | www.bsis.ca.gov
APPLICATION FOR SECURITY GUARD REGISTRATION
Application Fee $55.00
DO NOT LIVE SCAN UNTIL YOU HAVE SUBMITTED YOUR APPLICATION
Central
Records
Activity Code
01 |
Entity Number
License
Number
Agency
Use
Only
G
Cashiering
License
1201
Transaction
1020
$
Remitter Entity Number
Beneficiary Entity Number
R#
e#
e#
IMPORTANT: Read all instructions carefully. An incomplete or incorrect application may delay processing.
COMPLETE ELECTRONICALLY ON COMPUTER OR PRINT CLEARLY IF HANDWRITTEN
Last Name First Name Middle Name
SSN/ITIN:
Date of Birth (MM/DD/YYYY format):
Address of Record (Number and Street, City, State, & Zip Code):
Residence Address (Number and Street, City, State & Zip Code):
Telephone Number
:
Email Address
(
Optional
):
1.
Have you ever been convicted of, or pled guilty or nolo contendere to any offense in the United
States or foreign country?
This includes every citation, infraction, misdemeanor and/or felony,
including traffic violations. NOTE: Convictions that were adjudi
cated in the juvenile court or
convictions two years or older under California Health and Safety Code sections 11357(b), (c), (d),
(e) or section 11360(b) should not be reported. Notwithstanding the crimes specifically delineated
above, convictions that were later expunged from the records of the court or set aside pursuant to
section 1203.4 of the Penal Code or equivalent non-California law must be disclosed.
2. Is any criminal action pending against you, or are you currently awaiting judgment and sentencing
following entry of a plea or jury verdict?
Yes
No
Yes
No
U.S. ARMED FORCES/VETERAN APPLICANTS
Check box if you have served, or are currently serving, in the U.S. Armed Forces.
Check box if you are a spouse or domestic partner of an active duty member of the U.S. Armed Forces, who
is assigned to a California duty station, and you currently hold a security guard license in another state,
district or territory of the U.S.
Disclosure is voluntary. If you check either box and are seeking military-related expedited services, you must
provide additional information. Read
U.S. Armed Forces/Veteran Applicants information under Instructions
carefully to avoid delays in the processing of your application.
STOP
Rev. March 2020 Page 2 of 5
Check box if you are an ACTIVE DUTY PEACE OFFICER, as defined in Chapter 4.5 (commencing with section 830)
of Title 3 of Part 2 of the Penal Code, or a federal qualified law enforcement officer, as defined in section 926B of Title
18 of the United States Code.
Disclosure is voluntary. If you are seeking a peace officer exemption, check the box and provide additional
information for the Bureau to determine your eligibility. Read
Active Duty Peace Officer Exemptions
information under Instructions carefully to avoid delays in the processing of your application.
PROOF OF COMPLETING POWER TO ARREST TRAINING COURSE
Mandatory Disclosure Language
Submission of the requested information is required unless otherwise noted as optional. The Bureau of Security and Investigative
Services (BSIS) of the Department of Consumer Affairs (Department) cannot process your Security Guard Registration Initial
Application unless all required information is provided. Your fingerprints will be used to check the criminal history records of the FBI.
You have the opportunity to complete or challenge the accuracy of the information contained in the FBI identification record. The
procedures for obtaining a change, correction, or updating an FBI identification record are set forth in Title 28, Code of Federal
Regulations (CFR) Section 16.34. Procedures for obtaining a copy of the FBI criminal history record are set forth at Title 28, CFR
Section 16.30 through 16.33, which you can view by visiting https://www.edo.cjis.gov.
Pursuant to the Information Practices Act, the BSIS is responsible for maintaining the information in this application. You have the right
to review the records maintained on you by the BSIS or Department unless the records are exempt from disclosure by section 1798.40
of the Civil Code. Your completed application becomes the property of the BSIS and will be used by authorized personnel to determine
your eligibility for a security guard registration. Information on your application may be transferred to other governmental or law
enforcement agencies, as permitted by law.
Pursuant to the California Public Records Act (Gov. Code § 6250 et seq.) and the Information Practices Act (Civ. Code § 1798.61),
information about persons possessing a license, certificate, permit or registration may be disclosed by the BSIS unless otherwise
specifically exempt from disclosure under the law. The Address of Record of each licensee is not exempt from disclosure and will be
released upon request by a member of the public. The BSIS makes every effort to protect the exempt personal information you provide
us. Exempt information provided by you, however, may be disclosed in response to a court or administrative order, a subpoena, or a
search warrant.
Pursuant to Business and Professions Code section 30, providing your social security number is mandatory and will be used primarily
for tax enforcement purposes and for compliance with any judgment or order for family support in accordance with section 17520 of the
Family Code. If you fail to provide your social security number, you will be reported to the Franchise Tax Board (FTB), which may assess
a $100 penalty against you. Further, pursuant to section 30, subdivision (m), your social security number together with your name, date
of birth, and license information may be shared with the Office of the Chancellor of the California Community Colleges. The Bureau is
legally prohibited from processing your application if you fail to provide your social security number or individual taxpayer identification
number.
The State Board of Equalization (BOE) and the FTB may share taxpayer information with the BSIS. You are required to pay your state
tax obligation. This application may be denied, or your license may be suspended if the state tax obligation is not paid and your name
appears on either the BOE or FTB certified list of top 500 tax delinquencies.
For questions about this notice or access to your record, you may contact the BSIS by mail at Bureau of Security and Investigative
Services, Attn: Custodian of Record, P.O. Box 980550, Sacramento, CA 95798-0550; by phone at(800) 952-5210; or by e-mail at
bsis.prarequests@dca.ca.gov.
For questions about the Department’s Privacy Policy, you may contact the Department of Consumer
Affairs by mail at 1625 North Market Boulevard, Sacramento, CA 95834, by phone at (800) 952-5210 or by e-mail at dca@dca.ca.gov.
I DECLARE UNDER PENALTY OF PERJURY, UNDER THE LAWS OF THE STATE OF CALIFORNIA, THAT:
I personally completed this application;
To the best of my knowledge all statements on this application are true and correct;
I completed the 8-hour Power to Arrest training course required for a BSIS security guard registration or am
an active duty peace officer who has successfully completed a power to arrest course; and
With full knowledge that all statements herein are subject to investigation and that any false or dishonest
information provided on the application may be grounds for denial or subsequent revocation of my security
guard registration and any other license(s) I hold, or may subject me to criminal prosecution
.
Applicant Signature Date
BSIS License/Certificate/Approval Number
School/Business Phone Number (Optional) School/Business Name Where Training Completed
Date Training Completed Certificate of Completion Serial Number
A Security Guard applicant must complete the BSIS eight (8) hour "Power to Arrest" training including passage of the BSIS
Power to Arrest Training Manual exam with a 100% score. This training can be obtained from a BSIS Private Patrol
Operator licensee, a BSIS-certified training facility, or a BSIS-approved Power to Arrest Trainer.
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INSTRUCTIONS FOR COMPLETING APPLICATION
1. Fee Payment: An application received without full fee payment of the $55.00 fee will not be processed and
will be returned to applicant. Make your check payable to Bureau of Security and Investigative Services or
BSIS. Do not submit cash by mail. Application fees are non-refundable.
2. Allow sixty (60) days to process your application. DO NOT contact the Bureau to check on the status
of your application unless it is over 60 days from submission. The Bureau will notify you in writing in that 60
days if your application is deficient.
3. Make sure you are using a current Application for Security Guard Registration form. An incorrect or
outdated form could result in you having to submit a new application on the correct form. Refer to the
Bureau’s website to make sure you are using the most current form.
4. Provide fingerprints by one of the methods noted below. You must submit fingerprints with this
application even if you previously submitted fingerprints for another BSIS license.
Live Scan: Submit your fingerprints through a Department of Justice (DOJ) Live Scan provider using a
Security Guard Live Scan Form. Additional information regarding submitting fingerprints via Live Scan,
a list of Live Scan Forms, and a link to DOJ’s website for Live Scan provider locations can be found at
https://
www.bsis.ca.gov/forms_pubs/livescan/ . After submitting fingerprints, retain your Live Scan form
for your records.
ALERT: Per FBI guidelines, you must submit your application to the Bureau before
completing the Live Scan. To prevent application processing delays, keep a copy of the Live
Scan form, which must include the ATI number and the signature of the Live Scan Operator.
Checking on Status of Your Live Scan Results: You can check the status on the DOJ’s website at
https://applicantstatus.doj.ca.gov/. You must provide the ATI number from the bottom of your completed
Live Scan form and your date of birth. IMPORTANT: Unless the DOJ system specifically states
“California/FBI responses were sent to the agency,” the Bureau is still waiting for your results.
Hard Card Fingerprint Cards: If you are unable to submit fingerprints via Live Scan or live outside of
California and cannot access a Live Scan provider in this State, you must submit two fingerprint hard
cards and the required fingerprint card processing fee with this application. Instructions for submitting
fingerprint cards can be found at
https://www.bsis.ca.gov/forms_pubs/livescan/index.shtml.
5. Mail your application and $55 check or money order to:
Bureau of Security and Investigative Services
P.O. Box 989002
West Sacramento, CA 95798-9002
6. U.S. Armed Forces/Veteran Applicants: Checking an applicable box helps the Bureau to track applicants
who are current or former military personnel who may be eligible for services the Bureau provides via its
Veterans Come First Program. Only an individual who satisfies one of the following is authorized by law to
have the processing of their Application for Security Guard Registration expedited.
Applicant is Honorably Discharged Active Duty Member of the U.S Armed Forces: If you are
seeking expedited services under this designation, you must include a copy of your DD-214 or DD- 215
with your application as proof of having served as an active duty member of the U.S. Armed Forces and
being honorably discharged. (Business and Professions Code Section 115.4)
Applicant is a Spouse/Domestic Partner of Active Duty Member of U.S. Armed Forces, Who is
Assigned to a California Duty Station, and Holds a Current Security Guard License Elsewhere: If
you are seeking expedited services under this designation, you must include with your application a
copy of your Certificate of Marriage, Certificate of Domestic Partnership, or proof of other legal union; a
copy of your spouse’s/partner’s military orders reflecting assignment to a California duty station; and
proof of being licensed as a security guard in another state, or U.S. territory or district. (Business and
Professions Code Section 115.5)
7. Email Address: While optional, providing this information may expedite the Bureau’s communication with
you if additional information is required to process this application.
8. Address Information: By law, an applicant is required to provide their residence address to the Bureau.
The residence address can be designated as the Address of Record or the Confidential Address.
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Address of Record (AOR): This is the address that will appear on your registration and where the Bureau
will mail your registration and any future correspondence relating to your security guard registration. The
AOR is also the address that will be disclosed in response to public records requests and/or public sales
requests. If providing a Post Office Box or an address other than your residence address as your AOR, you
must provide your residence address.
Residence Address: If AOR is not your residence address, you must provide your residence address. The
residence address is confidential.
9. Active Duty Peace Officer Exemptions If you are an active duty peace officer, as defined in Chapter 4.5,
(commencing with section 830) of Title 3 of Part 2 of the California Penal Code or a federal qualified law
enforcement officer as defined in section 926B of Title 18 of the United States Code you may be exempt
from completing the BSIS Power to Arrest training course. If you are an active duty peace officer, as defined
in Chapter 4.5, (commencing with section 830) of Title 3 of Part 2 of the California Penal Code, you may be
exempt from the fingerprint requirement. (Business and Professions Code Sections 7583.6 and 7583.9)
Power to Arrest Exemption: If you are a California peace officer or federal law enforcement officer, as
specified above, and are seeking an exemption from completing the BSIS Power to Training Course,
you must provide proof of your sworn status and completion of a course of study in the power to arrest.
Verification of your active duty peace officer status can be satisfied by providing with your application a
legible copy of the front and back of your peace officer identification card. Acceptable proof of having
completed a course of study in the power to arrest includes providing a letter from your current
Commanding Officer attesting to your completion of a Power to Arrest training course; a copy of your
Basic or Specialized Basic POST course completion certificate, or the federal equivalent thereof; or a
copy of your POST profile detailing completion of the Basic or Specialized Basic training which includes
Power to Arrest training, or the federal equivalent thereof. See BSIS website at
www.bsis.ca.gov for
additional information regarding peace officer exemptions.
Exemption from Fingerprint Submission Requirement: If you are a California peace officer as
specified above and are seeking an exemption from the fingerprint requirement, you must provide proof
of your current sworn status. Verification of your active duty status can be satisfied by providing the
Bureau a legible copy of the front and back of your peace officer identification card. This exemption
does not apply if you are also applying for a BSIS Firearms Permit. NOTE: If you apply for a Security
Guard registration using the Live Scan exemption, you must report any change in your active
duty status to the Bureau within 72 hours of the change (BPC 7583.9). Failure to do so could
result in disciplinary action against your registration.
10. BSIS Power to Arrest Training Course Information: This 8-hour training course may be administered by
your employing BSIS-licensed Private Patrol Operator, any BSIS-certified Firearms or Baton Training
Facility, or any Bureau-approved school or business. Check the status of a training provider on the
Department of Consumer Affairs License Search at https://search.dca.ca.gov/. The training provider is
required to provide you a Certificate of Completion upon training completion. The certificate must contain
the training provider’s name and BSIS license number, certificate or approval number; Power to Arrest
course name; date of training; hours of training; instructor signature; and a unique, sequential serial number.
RETAIN THE CERTIFICATE ISSUED TO YOU FOR YOUR RECORDS AS PROOF OF HAVING
COMPLETED THE TRAINING.
Certificate of Completion Serial Number: Provide the serial number found on your Certificate of
Completion.
BSIS License/Certificate/Approval Number: If you completed training with your employing Private
Patrol Operator (PPO), then provide the PPO’s BSIS license number. If you completed training with a
Firearms or Baton Training Facility, then provide the training facility’s BSIS certificate number. If you
completed training with an approved trainer, then provide the trainer’s BSIS approval number.
Important Information After Issuance of a Security Guard Registration
1. Proof of Registration: Once the Bureau issues you a security guard registration, you may work with a
hardcopy printout of the approved security guard registration from the Department of Consumer Affairs
License Search at http://search.dca.ca.gov
along with a valid picture ID while waiting to receive the hardcopy
registration card in the mail.
2. Address Change: You must notify the Bureau of any change in your Address of Record or residence
address within 30 days from the date of change. Failure to provide timely notice could result in the issuance
of an administrative fine. An address change may be completed online through BreEZe if you
Rev. March 2020 Page 5 of 5
have a BreEZe account. Address changes submitted online through BreEZe are effective immediately. An
address change also may be submitted by completing an Address Change (Personal) Form and emailing it
to bsis@dca.ca.gov
or mailing it to P.O. Box 989002, West Sacramento, CA 95798-9002.
3. Required Training: A security guard registrant must complete the training below. You must retain your
training certificates of completion as proof of completing the required training.
a. Within six (6) months of Initial Registration: As a condition for the first renewal, you must complete
32 hours of security guard skills training within six months of registration, as follows:
i. At least 16 hours within 30 days of registration
ii. Additional 16 hours (for a total of 32 hours) within 6 months of registration
b. Annual Training: You must complete 8 hours of security guard skills training annually.
4. Security Guard Registrants Cannot Contract Out Their Services: By law, a security guard registrant
cannot contract out his/her services directly to any person or business. Instead, as a security guard, you
must be an employee of the person or business for which you are providing security services.
5. Renew Timely. By law, a security guard registration renewal application must be submitted at least 60 days
before expiration of the current registration. NOTE: Applications received more than 90 days before
expiration will be returned. Renewal options include:
Renewal Coupon: A security guard registration renewal coupon will be mailed to your address of record
approximately 90 days prior to your registration’s expiration. To help ensure you receive your renewal
coupon, provide timely notice of a change in your address of record to the Bureau. NOTE: Reporting a
change of address at the time of renewal will delay the renewal of your registration. Also, reporting a
change of address on the renewal coupon and failing to check the box on the face of the renewal coupon
to indicate that you are making an address change will result in your new guard registration card being
sent to your old address.
Renew with BreEZe: Using BreEZe is the quickest way to renew your registration. You must have your
security guard registration linked to a BreEZe account to renew online. For step-by-step tutorials on using
BreEZe, visit https://www.dca.ca.gov/webapps/breeze/tutorials.php.
Security Guard Registration Renewal Application: The current version of the application is available
on the Bureau’s website at www.bsis.ca.gov.
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