TO OBTAIN THE DISCOUNTED FINGERPRINTING PRICE PLEASE READ AND FILL OUT THE FORM BELOW. IF YOU DECIDE TO SET UP THE ACCOUNTS ON YOUR OWN, YOU WILL NOT RECEIVE THE DISCOUNTED PRICE AND YOUR APPOINTMENT WILL NOT BE SCHEDULED WITH YOUR GROUP.

FingerPrint Me, LLC, clearancecard.com will be submitting your application and fingerprints to the Department of Public Safety (DPS) to obtain a Fingerprint Clearance Card. Please provide us with the information from your Driver License/ID Card & your SSN# to complete the DPS application. We do not retain this information in our system, as it is used to set up your DPS application and your electronic fingerprint submission. If you'd like to view what is required on the DPS application to submit your fingerprints electronically please visit the azdps.gov website.

First Name *

Middle Initial

Only write in the name as it appears on your ID.

Last Name *

Email *

This email will be used to set up your application

Phone *

Date of birth *

Address Apt#, Unit#, Lot#, Ste#, Suite#

Address *

Physical Mailing Address - No PO BOX's *

City

State

Country

Postal code

SSN# (Social Security) *

Race *

Black, Hispanic, Caucasian, Japanese etc.

Citizenship *

If you are only a RESIDENT of U.S., please enter in the country that you are a citizen of.

City and State You Were Born (if outside of the U.S. then Country and City) Birth Place *

If born outside of the US, indicate which country you were born in

Sex *

This must be listed on your Identification

Hair Color *

Height *

This must be listed on your Identification

Weight *

Eye Color *

What part of the day is best to contact you to receive the DPS verification code? *

You will receive a verification code from DPS. Please provide this code to us immediately to proceed with your application. How should we contact you to receive the code? *

TEXT

PHONE CALL

Please respond during your time frame to get through this process quickly. We will be contacting you from (602) 770-0201 or by email from [email protected].

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