Fingerprint Redissemination Request Form PDF Details

In order to protect the privacy of employees, many organizations have fingerprint scanning systems in place as a form of identification. In some cases, however, an employee's fingerprints may need to be shared with another department or organization. The Fingerprint Redissemination Request Form allows employees to request that their fingerprints be shared with another party while still maintaining the confidentiality of their personal information. This form can be used in situations where an employee needs to provide their fingerprints for verification purposes or when they are transferring to a new department. completes the Fingerprint Redissemination Request Form and submits it to Human Resources.

QuestionAnswer
Form NameFingerprint Redissemination Request Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesRedissemRqst montana office of public instruction re dissemination form

Form Preview Example

Fingerprint Redissemination Request

 

Montana Office of Public Instruction

 

Denise Juneau, Superintendent

Attn: Educator Licensure

To contact Educator Licensure

Montana Office of Public Instruction

P.O. Box 202501

406-444-3150 or cert@mt.gov

 

Helena, MT 59620-2501

 

 

 

www.opi.mt.gov/cert

 

 

 

 

Admin. R. Mont. 10.57.201A requires all applicants for initial licensure or reinstatement of former licensure complete a fingerprint based background check.

If your fingerprint result is on file with the Office of Public Instruction, a Montana public school or public school district, or a unit of the Montana university system, those results can be distributed from one public education entity to another, as long as the result is less than 2 years old.

It is against FBI policy for results to be shared across state lines or from private institutions (colleges and universities, or private schools).

Applicant Information

Last Name

 

 

 

 

 

 

 

 

First Name

 

 

 

 

 

Middle Initial

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Folio ID (assigned by OPI)

 

 

 

 

 

 

 

 

 

Former Name(s) (Maiden or Other)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Birth

 

 

 

Last four digits of your SSN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I authorize

The Office of Public Instruction; or

a Unit of the Montana University System; or

Montana Public School or School District

Select a university

Enter name of school or district

to share the results of my fingerprint based background check with

The Office of Public Instruction; or

a Unit of the Montana University System; or

Select a

 

 

 

 

 

university

 

 

 

 

 

 

 

 

 

 

 

 

Montana Public School or School District.

Enter name of

 

 

school or district

 

 

 

 

 

 

 

 

 

 

 

 

 

If you are requesting the OPI to distribute your fingerprint results to a Montana university, or Montana public school or school district, please provide the name, address and telephone number of the specific person you wish to receive the background check results:

Recipient Name

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

 

 

Zip Code

 

 

 

 

 

Recipient Phone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of Applicant

 

 

 

 

 

Printed or typed

 

 

 

 

Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

name of applicant

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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This PDF form will need you to type in some specific details; in order to guarantee accuracy and reliability, please pay attention to the guidelines directly below:

1. Fill out the Fingerprint Redissemination Request Form with a selection of essential blank fields. Get all of the necessary information and make certain there is nothing neglected!

Filling out segment 1 of Fingerprint Redissemination Request Form

2. Once the prior section is done, go to enter the relevant details in all these - a Unit of the Montana University, Montana Public School or School, Select a university, Enter name of school or district, If you are requesting the OPI to, Recipient Name, Address, City, State, Zip Code, Recipient Phone, Signature of Applicant, Printed or typed name of applicant, and Date.

If you are requesting the OPI to, Zip Code, and Printed or typed name of applicant in Fingerprint Redissemination Request Form

Regarding If you are requesting the OPI to and Zip Code, make sure that you double-check them here. These two are viewed as the most important fields in the page.

Step 3: Prior to obtaining the next stage, double-check that form fields are filled out the proper way. The moment you establish that it's correct, click on “Done." Join us today and easily use Fingerprint Redissemination Request Form, all set for downloading. Every edit you make is conveniently kept , helping you to customize the file later on when required. FormsPal is committed to the personal privacy of our users; we make sure all personal data going through our system is secure.

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