Form BCIA 8016 at a glance
What it is: BCIA 8016 (Rev. 03/2024) is the Request for Live Scan Service of the State of California Department of Justice.
Who signs: Applicant Signature.
The CJIS Division uses this information to process requests of authorized entities that want to obtain information as to the existence and content of a record of state or federal convictions to help determine suitability for employment, or volunteer work with children, elderly, or disabled; or for adoption or purposes of a license, certification, or permit.
A filled-in Form BCIA 8016 example: a license applicant requests a DOJ check
How to fill out Form BCIA 8016, box by box
Applicant Submission
Enter the ORI (Code assigned by DOJ) and the Authorized Applicant Type.
Enter the Type of License/Certification/Permit OR Working Title (Maximum 30 characters - if assigned by DOJ, use exact title assigned).
Contributing Agency Information
Under Contributing Agency Information, enter the Agency Authorized to Receive Criminal Record Information, its Mail Code (five-digit code assigned by DOJ) and its State.
Enter the Contact Name (mandatory for all school submissions).
Applicant Information
Enter your Last Name, First Name, Middle Initial and Suffix, and any Other Name: (AKA or Alias).
Enter your Sex (Male, Female or Nonbinary/Unspecified), Date of Birth, Driver's License Number, Height, Weight, Eye Color, Hair Color, Place of Birth (State or Country) and Social Security Number.
Enter the Billing Number (Agency Billing Number) and the Misc. Number (Other Identification Number).
Enter your Home Address: Street Address or P.O. Box, City, State and ZIP Code.
Privacy Notice and Date
I have received and read the included Privacy Notice, Privacy Act Statement, and Applicant's Privacy Rights. Enter the Date.
Level of Service
Level of Service: DOJ FBI. If the Level of Service indicates FBI, the fingerprints will be used to check the criminal history record information of the FBI.
In the Your Number box, enter the OCA Number (Agency Identifying Number).
If re-submission, list original ATI number: (Must provide proof of rejection).
Employer
Employer (Additional response for agencies specified by statute): enter the Employer Name, Street Address or P.O. Box, City, State, ZIP Code, Mail Code (five digit code assigned by DOJ) and Telephone Number (optional).
More rules for Form BCIA 8016
You must be provided, and acknowledge receipt of, an adequate Privacy Act Statement when you submit your fingerprints and associated personal information.
If you have a criminal history record, the officials making a determination of your suitability for the employment, license, or other benefit must provide you the opportunity to complete or challenge the accuracy of the information in the record.
Before you go
All the personal information requested in the form must be provided. Failure to provide all the necessary information will result in delays and/or the rejection of your request.
Sources
[1] Form BCIA 8016 Request for Live Scan Service (Rev. 03/2024), California Department of Justice (the Official source link on this page).
