Appointment Time * Type of Photo ID and ID * Select one Passport State ID Driving License Name * State / Province * Alabama Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho IllinoisIndiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri MontanaNebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon PennsylvaniaRhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming City * City Abingdon, VA Acton, MA Akron, OH Alachua County, FL Alameda, CA Albany, CA Albany, NY Albemarle County, VA Alexandria, VA Algonquin, IL Allegheny County, PA Alliance, OH American Canyon, CA Amherst, MA Ann Arbor, MI Antioch, CA Arlington County, VA Arlington, TX Arroyo Grande, CA Arvada, CO Asheville, NC Ashland, OR Aspen, CO Atascadero, CA Athens-Clarke County, GA Athens, OH Atlanta, GA Auburn, WA Austin, TX Ayer, MA Babylon, NY Bainbridge Island, WA Barnstable, MA Beaverton, OR Bedford, NY Belfast, ME Bellevue, WA Bellingham, WA Belmar, NJ Belmont, MA Belvedere, CA Benicia, CA Berea, KY Berkeley, CA Beverly Hills, CA Binghamton, NY Blacksburg, VA Blaine County, ID Bloomington, IN Blue Earth County, MN Boston, MA Bothell, WA Boulder, CO Bowie, MD Boynton Beach, FL Bozeman, MT Branford, CT Breckenridge, CO Bridgeport, CT Brighton, NY Brookfield, IL Brookhaven, NY Brookline, MA Broward County, FL Bryan, TX Burlingame, CA Burlington, VT Calistoga, CA Cambridge, MA Carbondale, CO Carmel, IN Carpinteria, CA Carrboro, NC Carroll County, MD Carver, MA Cary, NC Champaign, IL Chandler, AZ Chapel Hill, NC Charleston, SC Charlotte, NC Charlottesville, VA Chatham County, GA Chatham County, NC Chatham, NY Chattanooga, TN Chelmsford, MA Chevy Chase, MD Chicago, IL Chula Vista, CA Cimarron, NM Cincinnati, OH Clackamas County, OR Clallam County, WA Clark County, NV Clarkstown, NY Clayton, MO Clermont, NY Cleveland, OH Clifton, NJ Cloverdale, CA College Park, MD College Station, TX Collier County, FL Columbia, MO Columbia, SC Concord, CA Concord, MA Cookeville, TN Cooperstown, NY Coppell, TX Cortlandt, NY Corvallis, OR Coupeville, WA Cranberry Township, PA Creve Coeur, MO Croton on Hudson, NY Culver City, CA Cupertino, CA Cutler Bay, FL Dallas, TX Dane County, WI Danville, CA Davie, FL Davis, CA Dearborn, MI Decatur, GA Decorah, IA Dedham, MA Del Mar, CA Delray Beach, FL Denton, TX Denver, CO Devens, MA DeWitt, NY Dixon, CA Dobbs Ferry, NY Dryden, NY Duarte, CA Dublin, CA Dubuque, IA Duluth, MN Dumfries, VA Durango, CO Durham, NC East Palo Alto, CA East Whiteland Township, PA Eastchester, NY Edina, MN Edinburg, TX Edmonds, WA Edwardsville, IL El Cerrito, CA El Paso, TX Elmhurst, IL Emeryville, CA Encinitas, CA Essex, CT Eugene, OR Everett, WA Fairbanks North Star Borough, AK Fairfax, CA Fairfield, IA Fairfield, CA Fairmont, WV Falls Church, VA Falls, PA Falmouth, ME Fayetteville, AR Fayetteville, WV Ferndale, MI Fitchburg, WI Flagstaff, AZ Flint, MI Forest Hills, PA Fort Collins, CO Fort Lauderdale, FL Fort Wayne, IN Foster City, CA Frankfort, KY Franklin, TN Fremont, CA Fullerton, CA Gainesville, FL Gaithersburg, MD Gatlinburg, TN Geneva, NY Georgetown, TX Glendale, CA Golden Valley, MN Golden, CO Goodyear, AZ Grand Forks, ND Grand Rapids, MI Grand Traverse County, MI Grapevine, TX Greenbelt, MD Greenburgh, NY Greenville, SC Groton, CT Guadalupe, CA Gunnison County, CO Hailey, ID Hamilton County, TN Hamilton, NJ Harrisonburg, VA Hastings on Hudson, NY Haverford, PA Hawaii County, HI Hayward, CA Helena, MT Henderson, NV Hennepin County, MN Hermosa Beach, CA Hillsboro, OR Hillsborough, CA Hingham, MA Homer, AK Houston, TX Howard County, MD Howard, WI Humboldt County, CA Hunter, NY Huntington, NY Huntsville, AL Hyattsville, MD Inglewood, CA Iowa City, IA Ipswich, MA Irvine, CA Irving, TX Issaquah, WA Ithaca (City), NY Ithaca (Town), NY James City County, VA Johnson County, IA Johnson County, KS Juneau, AK Kansas City, MO Keene, NH Key West, FL King County, WA Kingston, MA Kirkland, WA Kirkwood, MO Knoxville, TN Kodiak, AK La Grange Park, IL La Mirada, CA La Plata County, CO Lacey, WA Lafayette, CA Lake Elsinore, CA Lake Forest, IL Lake Oswego, OR Lake Worth, FL Lakewood, CA Larchmont, NY Las Cruces, NM Las Vegas, NV Lawrence, KS Lee County, FL Lee's Summit, MO Leon County, FL Lewes, DE Lexington-Fayette County, KY Lexington, VA Lincoln City, OR Livermore, CA Lomita, CA Los Alamos County, NM Los Altos Hills, CA Los Angeles County, CA Los Gatos, CA Loudoun County, VA Loveland, CO Lowell, MA Lower Makefield, PA Lower Southampton, PA Lynchburg, VA Lynnwood, WA Madison, WI Mahtomedi, MN Maitland, FL Mamaroneck (Town), NY Mamaroneck (Village), NY Manitou Springs, CO Mankato, MN Maplewood, NJ Marathon, FL Maricopa County, AZ Marlboro, NJ Marshfield, MA Marshfield, WI Martinez, CA McMinnville, OR Meadville, PA Medford, MA Mendocino County, CA Menlo Park, CA Merced, CA Mercer Island, WA Miami Gardens, FL Miami, FL Miami-Dade County, FL Middletown, PA Mill Valley, CA Millbrae, CA Milpitas, CA Milton, MA Milwaukee, WI Milwaukie, OR Minneapolis, MN Mission, KS Missoula, MT Monmouth County, NJ Monroe County, FL Monterey, CA Montgomery Township, PA Moorpark, CA Moraga, CA Morgan County, GA Morro Bay, CA Mount Kisco, NY Mountain View, CA Mt. Lebanon, PA Muncie, IN Murrieta, CA Nantucket, MA Napa County, CA Napa, CA Narberth, PA Nashua, NH Nashville, TN Natick, MA National City, CA Nether Providence, PA New Brunswick, NJ New Castle, NY New Haven, CT New London, CT New Orleans, LA New Paltz (Town), NY New Rochelle, NY New York, NY Newark, CA Newark, NJ Newburyport, MA Norfolk, VA Norman, OK North Andover, MA North Castle, NY North Hempstead, NY North Las Vegas, NV North Liberty, IA North Little Rock, AR North Miami, FL Northampton, MA Northbrook, IL Novato, CA Oak Harbor, WA Oak Park, IL Oak Ridge, TN Oakdale, MN Oakland, CA Oakley, CA Oberlin, OH Ogdensburg, NY Olivette, MO Olympia, WA Omaha, NE Onondaga County, NY Orange County, FL Orange County, NC Orangetown, NY Orinda, CA Orlando, FL Ormond Beach, FL Oshkosh, WI Ossining (Town), NY Ossining (Village), NY Oswego, IL Oxford, OH Pacifica, CA Palm Bay, FL Palm Beach County, FL Palm Springs, CA Palmdale, CA Palo Alto, CA Park City, UT Parlier, CA Passaic County, NJ Peekskill, NY Penn Hills, PA Penndel Borough, PA Peoria, AZ Philadelphia, PA Phoenix, AZ Pinecrest, FL Pinellas County, FL Pittsburg, CA Pittsburgh, PA Plano, TX Plantation, FL Port Townsend, WA Portland, ME Portland, OR Portola Valley, CA Portsmouth, NH Pound Ridge, NY Prairie Village, KS Prince George's County, MD Providence, RI Pulaski County, AR Queen Anne's County, MD Quincy, MA Radnor, PA Raleigh, NC Rancho Cucamonga, CA Red Hook, NY Redmond, WA Redwood City, CA Renton, WA Richardson, TX Richmond, CA Richmond, VA Ridgefield, CT Riverside, CA Riverside, MO Roanoke County, VA Roanoke, VA Rochester, MN Rochester, NY Rock Island, IL Rockford, IL Rockville, MD Rolling Hills Estates, CA Rolling Hills, CA Rosendale, NY Roseville, MN Rye, NY Sacramento County, CA Sacramento, CA Saint George, UT Saint Helena, CA Saint Louis County, MO Saint Louis, MO Saint Paul, MN Salem, MA Salinas, CA Salisbury, MD Salt Lake City, UT San Anselmo, CA San Antonio, TX San Bruno, CA San Buenaventura (Ventura), CA San Carlos, CA San Clemente, CA San Diego, CA San Francisco, CA San Jose, CA San Leandro, CA San Luis Obispo, CA San Mateo County, CA San Mateo, CA San Miguel County, CO San Pablo, CA San Rafael, CA San Ramon, CA Santa Ana, CA Santa Barbara County, CA Santa Barbara, CA Santa Clara County, CA Santa Clara, CA Santa Clarita, CA Santa Cruz, CA Santa Fe, NM Santa Monica, CA Santa Rosa, CA Sarasota County, FL Sarasota, FL Saratoga Springs, NY Saugerties, NY Savannah, GA Seaside, CA SeaTac, WA Seattle, WA Seminole County, FL Sequim, WA Sequim, WA Shoreline, WA Sierra Madre, CA Signal Mountain, TN Silver City, NM Sioux Falls, SD Sitka, AK Skagit County, WA Snohomish County, WA Solana Beach, CA Solano County, CA Somers, NY Somerset County, NJ Sonoma City, CA Sonoma County, CA South Bend, IN South Burlington, VT South Daytona, FL South Gate, CA South Miami, FL South Padre Island, TX South Portland, ME Southampton (Town), NY Southampton (Village), NY Spartanburg County, SC Spartanburg, SC Spokane, WA Springfield, IL St. Lawrence County, NY Stamford, CT Staunton, VA Stonington, CT Suffolk County, NY Summit County, UT Sumter, SC Sunnyvale, CA Syracuse, NY Tacoma, WA Takoma Park, MD Tallahassee, FL Tamarac, FL Tampa, FL Taos, NM Tarrytown, NY Temecula, CA Tempe, AZ Tewksbury, MA Texarkana, TX Thurston County, WA Tiburon, CA Tompkins County, NY Town and Country, MO Tracy, CA Traverse City, MI Tuckahoe, NY Tucson, AZ Tulsa, OK Tumwater, WA Tybee Island, GA Tyngsborough, MA Union City, CA University City, MO Urbana, IL Vacaville, CA Vallejo, CA Venice, FL Ventura County, CA Vernon,CA Victor, NY Virginia, MN Visalia, CA Vista, CA Volusia County, FL Walnut Creek, CA Waltham, MA Warwick Township Washington, DC Washoe County, NV Washtenaw County, MI Wellesley, MA West Chester, PA West Palm Beach, FL West Sacramento, CA West Windsor, NJ Westchester County, NY Westminster, CO Whatcom County, WA Williamstown, MA Willits, CA Wilton, CT Winchester, MA Windsor, CA Windsor, CT Winston-Salem, NC Wolfeboro, NH Woodbury Woodside, CA Woodstock, NY Worcester, MA Wyandotte County/Kansas City, KS Yarmouth, ME Yonkers, NY York, ME Youngstown, OH Yountville, CA Zipcode * Phone * Email Address * Gender * Select gender Male Female Race * Select Race American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Hispanic or Latino Not Hispanic or Latino Other Height (Feet) * Height (inches) * Weight * Hair color * Eyes color * Result type * Choose result type Digital Physical Reason for background check: (BE SPECIFIC) * Direct Copy Options (Select only one) Other Option Applicant ID/Driving License/Passport *
I certify that the personal identifiers provided on this form are accurate and I voluntarily and knowingly authorize the Ohio Bureau of Criminal Identification & Investigation to conduct a criminal records check for the information relating to me. I also voluntarily and knowingly authorize BCI&I to disseminate criminal arrest, conviction and juvenile delinquency adjudication records to.....................I voluntarily and knowingly release and discharge the Ohio Attorney General's Office, BCI&I and their employees from all claims and liability related to this authorized criminal record review and dissemination.
Applicant's Name (please print) *