Puyallup Police Department Online Fingerprints Application

Welcome! This is an official order form for fingerprinting services. You must completely and accurately fill-out this application to be considered for finrgerprinting.

The fee for fingerprinting is $10.00 for the first card, $3.00 for each additional card. In addition, a service fee of $5.00 is required to process payment if paying online and using a credit/debit card.

Applicant Information:

Last Name: ^{(official ID)}

First Name:

Middle Name:

Maiden Name:

Suffix: ^{(jr, sr, etc.)}

SSN:

SSN: ^(confirm)

Previous or Other Names/Aliases: ^{(please list all previous aliases/names and maiden names)}

Previous Last Name	Previous First Name	Previous Middle Name

Information Related To Your Birth:

Date of Birth:

Current Age:

Birth City:

Birth State:

Birth County:

Birth Country:

Citizenship Country:

Height:

^feet ^inches

Weight:

Hair Color:

Eye Color:

Scars/Marks/Tattoos:

Current Residence Address: ^{(this may be different than your mailing address)}

Address Line 1:

Address Line 2:

City:

State : ^(region)

Zip Code: ^{(postal code)}

Country:

^{Mailing Address Different:}

Yes No

Present Mailing Address: ^{(if different from residence address)}

Address Line 1:

Address Line 2:

City:

State : ^(region)

Zip Code: ^{(postal code)}

Country:

Work Information And Address: ^{(enter your place of employment)}

Employer Name:

Address Line 1:

Address Line 2:

City:

State : ^(region)

Zip Code: ^{(postal code)}

Country:

Telephone Number: ^{(###-###-####)}

^Primary:

^Work:

^{Mobile Phone:}

^Fax:

Updates via text message?

Yes No

Email:

^Address:

^Confirm:

Please Create A Password: ^{(you can use this to track progress, and we may need to contact you during the process)}

Password:

Password: ^(confirm)

Password Information: In order to comply with CJIS standards we have employed the use of a password complexity monitor. As you enter your password, we will display an indicator of complexity. You will only be able to submit passwords that are sufficiently complex as to be considered 'safe' by CJIS standards. The visual indicator will turn Blue or Green to indicate that your password is safe.

Important: CJIS requires we maintain a strict password policy and system of checks. As such, we check the following items as you enter your new password:

The password must be a minimum length of eight (8) characters on all systems
The password must not be a dictionary word
The password must not be the same as your email address
The password must not be a proper name

Select Purchase Option:

1 Fingerprint Card 2 Fingerprint Cards 3 Fingerprint Cards 4 Fingerprint Cards 5 Fingerprint Cards Adoption (10 Cards) Dealer License

Total Fee:

$0

I DO HEREBY CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I ALSO UNDERSTAND THAT ANY FALSIFICATION OF THE ABOVE INFORMATION WILL RESULT IN THE REFUSAL TO COMPLETE THE PROCESS OF FINGERPRINTING.

Your Initials:

Application Qualification Questions:

Yes No

I acknowledge that this fingerprint service request is NOT for a Concealed Pistol License application.

YES! I would like to make a donation to Behind the Badge Foundation, a 501(c)(3) charitable organization dedicated to injured and fallen officers and their families in Washington during their time of need. (Please select the checkbox to donate)

Your support provides:

Funeral and living expenses after a line of duty death for spouses and families
Funding for the Line of Duty Death Response Team
Injured officer family needs (i.e. assistance with medical bills)

If you have any questions about ways in which the donation may be used, please call 425-747-7523 or email info@behindthebadgefoundation.org. Through your donation you may also receive an email from BtBF. Visit www.behindthebadgefoundation.org for more information.

Donation Amount:

Your Initials:

Back To Previous Step

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

← prior month
← prior week

first available →
next week →
next month→

None Selected

Your support provides:

Funeral and living expenses after a line of duty death for spouses and families
Funding for the Line of Duty Death Response Team
Injured officer family needs (i.e. assistance with medical bills)

Donation Amount:

SIGNING THIS APPLICATION AUTHORIZES THE WASHINGTON HEALTH CARE AUTHORITY, AS WELL AS MENTAL-HEALTH INSTITUTIONS AND OTHER HEALTH-CARE FACILITIES, TO RELEASE INFORMATION RELEVANT TO YOUR ELIGIBILITY FOR A CONCEALED PISTOL LICENSE TO AN INQUIRING COURT OR LAW-ENFORCEMENT AGENCY. I CERTIFY UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.

CAUTION: ALTHOUGH STATE AND LOCAL LAWS DO NOT DIFFER, FEDERAL LAW AND STATE LAW ON THE POSSESSION OF FIREARMS DIFFER. IF YOU ARE PROHIBITED BY FEDERAL LAW FROM POSSESSING A FIREARM, YOU MAY BE PROSECUTED IN FEDERAL COURT. A STATE LICENSE IS NOT A DEFENSE TO FEDERAL PROSECUTION

Coupon Code:

Your Initials:

Back To Previous Step

Puyallup Police Department

Fingerprints Online Scheduling / Application Please Enter All Information

Applicant Information:

Previous or Other Names/Aliases: ^{(please list all previous aliases/names and maiden names)}

Information Related To Your Birth:

Demographic Information:

Current Residence Address: ^{(this may be different than your mailing address)}

Present Mailing Address: ^{(if different from residence address)}

Work Information And Address: ^{(enter your place of employment)}

Telephone Number: ^{(###-###-####)}

Email:

Please Create A Password: ^{(you can use this to track progress, and we may need to contact you during the process)}

Select Purchase Option:

Total Fee:

$0

Application Qualification Questions:

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

Fingerprints Online Scheduling / Application Please Enter All Information

Add An Address

Applicant Information:

Previous or Other Names/Aliases: (please list all previous aliases/names and maiden names)

Information Related To Your Birth:

Demographic Information:

Current Residence Address: (this may be different than your mailing address)

Present Mailing Address: (if different from residence address)

Work Information And Address: (enter your place of employment)

Telephone Number: (###-###-####)

Email:

Please Create A Password: (you can use this to track progress, and we may need to contact you during the process)

Select Purchase Option:

Total Fee:

$0

Application Qualification Questions:

You Must Select An Appointment: your appointment will be confirmed prior to checkout

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

Your Appointment Choice Is:

No Appointments Available

Additional Information Required

Error processing application

Donations cant be taken with cash

Previous or Other Names/Aliases: ^{(please list all previous aliases/names and maiden names)}

Current Residence Address: ^{(this may be different than your mailing address)}

Present Mailing Address: ^{(if different from residence address)}

Work Information And Address: ^{(enter your place of employment)}

Telephone Number: ^{(###-###-####)}

Please Create A Password: ^{(you can use this to track progress, and we may need to contact you during the process)}

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}