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LR LIVESCAN Digital Fingerprinting
First Name
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Your answer
Middle Name
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Your answer
Last Name
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Your answer
Place of Birth (City, State)
*
Your answer
Date of Birth
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MM
/
DD
/
YYYY
Sex
Male
Female
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Race
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Black or African American
White
American Indian or Alaska Native
Asian
Native Hawaiian or Other Pacific Islander
Hispanic or Latino
Other:
Height
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Your answer
Weight
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Your answer
Eye Color
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Your answer
Hair Color
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Your answer
Physical Mailing Address (City, State, Zip)
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Your answer
Employer and Employer Address (City, State, Zip)
*
Your answer
Reason for Fingerprinting
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Your answer
Cellphone
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Your answer
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