Form Bcia 8372 PDF Details

Form Bcia 8372, also known as the "Tax Exempt Organization Information Return" is a document that tax-exempt organizations are required to file annually with the IRS. The form provides information on the organization's activities and finances, and must be filed by May 15th of every year. Failing to submit Form Bcia 8372 may result in penalties and fines. For more information on this form and how to complete it, please consult the IRS website.

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Form NameForm Bcia 8372
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
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STATE OF CALIFORNIA

BCIA 8372

(Orig. 07/2006; Rev. 12/2010)

DEPARTMENT OF JUSTICE

PAGE 1 of 1

APPLICATION FOR CERTIFICATION

of Non-Exempted Individuals to Take Fingerprint Impressions

(Penal Code section 11102.1)

Please Type or Print Your Responses

Last Name

Address

Phone Number

 

First Name

 

Middle Name

 

 

 

 

City

 

 

State

 

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Birth

SSN (Mandatory)

 

Driver's License or

 

CA ID Number

 

 

 

 

 

 

 

 

 

Please answer fully the following questions:

1.

Are you a legal resident of California?

 

Yes

 

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

Have you ever used a name other than the one on this application?

 

 

Yes

 

No If yes, please list other names below.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

Have you ever been arrested in California or any other state?

 

 

 

Yes

 

 

 

No

 

If yes, give details below.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.Are you currently awaiting adjudication for any offense for which you were arrested in California or any other state?

 

Yes

 

No

If yes, give details below.

5. Have you ever been convicted by any court of a felony or misdemeanor offense in California or any other state?

 

Yes

 

No

 

 

If yes, disclose the date and place of arrest, whether the conviction was for a felony or misdemeanor, and the sentence imposed.

 

 

6.Have you ever been denied a professional license or had such license revoked, suspended, or restricted?

Yes

 

No

If yes, give details below.

7.Have you ever been adjudged liable for damages in any suit grounded in fraud, misrepresentation, or in violation of state regulatory laws? If yes, give details below.

 

Yes

 

No

8.Have you ever failed to satisfy any court ordered money judgment including restitution?

Yes

 

No

If yes, give details below.

Misrepresentation or Failure to Disclose Requested Information on this Application

Is Cause for Denial or Revocation of Certification.

Certification

I certify that I have read the pre-certification materials provided by the Department of Justice. I certify under penalty of perjury under the laws of the State of California to the truth and accuracy of all statements, answers, and representations made in the foregoing application, including all supplementary statements.

Signature of Applicant

Date

Privacy Notice

The information on this form is requested by the State of California, Department of Justice (DOJ), California Justice Information Services Division, Fingerprint Rolling Certification Program, for the purpose of providing fingerprint-based Criminal Offender Record Information background checks on individuals who roll applicant fingerprint impressions manually or electronically for non-law enforcement purposes (licensure, employment, or certification). The maintenance of the information collected on this form is authorized by Penal Code 11102.1. All information requested on this form is mandatory. Failure to provide the requested information will result in denial of the application. Information provided on this form may be disclosed to other law enforcement, regulatory agencies, or businesses where the transfer is necessary to perform its statutory duties.

Pursuant to Civil Code Section 1798.30 et seq., individuals have the right [with some exceptions] to access records containing the personal information about them that is maintained by the agency. The Department of Justice is the agency official responsible for the system of records that maintains the information provided on this form. For more information regarding the location of your records and the categories of any persons who use the information in those records, you may contact the Fingerprint Rolling Certification Program, Department of Justice, at P.O. Box 903387, Sacramento, CA 94203-3870, or via telephone at (916) 227-6420, or e-mail at FPCERT@doj.ca.gov.

California Department of Justice

Applicant Information and Certification Branch

Fingerprint Rolling Certification

P.O. Box 903387

Sacramento, CA 94203-3870

(916) 227-6420

 

 

DOJ USE ONLY

Cert #:

 

 

 

Fee:

 

 

 

 

 

 

 

 

Received:

 

 

OCA #:

 

 

Completed:

 

 

 

 

 

 

 

 

 

 

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How to prepare Form Bcia 8372 portion 1

2. When the previous segment is completed, you're ready to add the needed particulars in Have you ever been denied a, Yes, If yes give details below, Have you ever been adjudged liable, Yes, Have you ever failed to satisfy, Yes, If yes give details below, Misrepresentation or Failure to, Is Cause for Denial or Revocation, Certification I certify that I, Signature of Applicant, Date, Privacy Notice, and The information on this form is in order to proceed further.

Form Bcia 8372 completion process described (portion 2)

3. The next section is considered quite straightforward, DOJ USE ONLY, California Department of Justice, Applicant Information and, Fingerprint Rolling Certification, PO Box, Sacramento CA, Cert, Received, Completed, Fee, and OCA - all these fields must be filled out here.

Completed, California Department of Justice, and Fingerprint Rolling Certification inside Form Bcia 8372

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