FBI Fingerprinting
First Name
Middle
Last
Date of Birth
/
Month
/
Day
Year
Date
City of Birth
Birth State
SS#
Sex
Male
Female
Race
Asian or Pacific Islander
Black
American Indian & Alaskan Native
Unknown
White - Includes Latinos
Eye Color:
Black
Blue
Green
Gray
Hazel
Brown
Maroon
Multicolored
Pink
Unknown
Hair Color
Black
Blonde
Blue
Brown
Grey
Orange
Purple
Pink
Red
Sandy
White
Unknown
Weight
Height
Preferred Week Day/Time for Appt.
For appointment
Country of Citizenship
Driver's License Number
Exp.
Address
Address
Street Address Line 2
City
State / Province
Postal / Zip Code
State
Zip
Phone
Alias Used
Email Address
example@example.com
PENNSYLVANIA STATE POLICE
Personal Information
Subject of Record Check
(FIRST)
(MIDDLE)
(LAST)
MAIDEN NAME AND/OR ALIASES
SOCIAL SECURITY NUMBER
DATE OF BIRTH (MM/DD/YYYY)
/
Month
/
Day
Year
Date
SEX
Please Select
M
F
U
RACE
Please Select
Asian
Black
American Indian
White
Unknown
Submit
Should be Empty: