Scott County Sheriff's Office Fingerprint Application

Welcome! This is an official order form for fingerprinting services. You must completely and accurately fill-out this application to be considered for finrgerprinting. A non-refundable processing fee of $20.00 is required.

Applicant Information:

Last Name: ^{(official ID)}

First Name:

Middle Name:

Maiden Name:

Suffix: ^{(jr, sr, etc.)}

SSN:

SSN: ^(confirm)

Previous Aliases: ^{(please list all previous aliases)}

Previous Last Name	Previous First Name	Previous Middle Name

Information Related To Your Birth:

Date of Birth:

Current Age:

Birth City:

Birth State:

Birth County:

Birth Country:

Citizenship Country:

Height:

^feet ^inches

Weight:

Hair Color:

Eye Color:

Physical Description:

Current Residence Address: ^{(this may be different than your mailing address)}

Address Line 1:

Address Line 2:

City:

State : ^(region)

Zip Code: ^{(postal code)}

Country:

^{Mailing Address Different:}

Yes No

Present Mailing Address: ^{(if different from residence address)}

Address Line 1:

Address Line 2:

City:

State : ^(region)

Zip Code: ^{(postal code)}

Country:

Work Information And Address: ^{(enter your place of employment)}

Employer Name:

Address Line 1:

Address Line 2:

City:

State : ^(region)

Zip Code: ^{(postal code)}

Country:

Telephone Number: ^{(###-###-####)}

^Primary:

^Work:

^{Mobile Phone:}

^Fax:

Updates via text message?

Yes No

Email:

^Address:

^Confirm:

Please Create A Password: ^{(you can use this to track progress, and we may need to contact you during the process)}

Password:

Password: ^(confirm)

Password Information: In order to comply with CJIS standards we have employed the use of a password complexity monitor. As you enter your password, we will display an indicator of complexity. You will only be able to submit passwords that are sufficiently complex as to be considered 'safe' by CJIS standards. The visual indicator will turn Blue or Green to indicate that your password is safe.

Important: CJIS requires we maintain a strict password policy and system of checks. As such, we check the following items as you enter your new password:

The password must be a minimum length of eight (8) characters on all systems
The password must not be a dictionary word
The password must not be the same as your email address
The password must not be a proper name

Select Purchase Option:

Copies of Fingerprints

Reason for Request of Fingerprinting:

Total Fee:

$0

I DO HEREBY CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I ALSO UNDERSTAND THAT ANY FALSIFICATION OF THE ABOVE INFORMATION WILL RESULT IN THE REFUSAL TO COMPLETE THE PROCESS OF FINGERPRINTING.

Your Initials:

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

← prior month
← prior week

first available →
next week →
next month→

None Selected

Coupon Code:

Your Initials:

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<p class="lead">Scott County Sheriff's Office Iowa Fingerprint Application

Fingerprints Online Scheduling / Application Please Enter All Information

Applicant Information:

Previous Aliases: ^{(please list all previous aliases)}

Information Related To Your Birth:

Demographic Information:

Current Residence Address: ^{(this may be different than your mailing address)}

Present Mailing Address: ^{(if different from residence address)}

Work Information And Address: ^{(enter your place of employment)}

Telephone Number: ^{(###-###-####)}

Email:

Please Create A Password: ^{(you can use this to track progress, and we may need to contact you during the process)}

Select Purchase Option:

Reason for Request of Fingerprinting:

Total Fee:

$0

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

Fingerprints Online Scheduling / Application Please Enter All Information

Add An Address

Applicant Information:

Previous Aliases: (please list all previous aliases)

Information Related To Your Birth:

Demographic Information:

Current Residence Address: (this may be different than your mailing address)

Present Mailing Address: (if different from residence address)

Work Information And Address: (enter your place of employment)

Telephone Number: (###-###-####)

Email:

Please Create A Password: (you can use this to track progress, and we may need to contact you during the process)

Select Purchase Option:

Reason for Request of Fingerprinting:

Total Fee:

$0

You Must Select An Appointment: your appointment will be confirmed prior to checkout

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

Your Appointment Choice Is:

No Appointments Available

Additional Information Required

Error processing application

Donations cant be taken with cash

Previous Aliases: ^{(please list all previous aliases)}

Current Residence Address: ^{(this may be different than your mailing address)}

Present Mailing Address: ^{(if different from residence address)}

Work Information And Address: ^{(enter your place of employment)}

Telephone Number: ^{(###-###-####)}

Please Create A Password: ^{(you can use this to track progress, and we may need to contact you during the process)}

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}