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Get Mi Ri-030 2017

, failure to complete this form will result in denial of request. Purpose: To conduct a civil fingerprint-based background check for employment, to volunteer, or for licensing purposes as authorized by law. Instructions: See page two. I. Authorizing Information: 1. Fingerprint Code 2. Requestor/Agency ID 3. Agency Name 4. Individual ID (optional) LDE 3720E Department of State II. Applicant Information: Type or clearly print answers in all fields before going to be fingerprinted. 1a. Last.

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