State of Illinois Department of Financial & Professional RegulationIllinois Department of Financial and Professional Regulation DivisionState of Illinois Department of Financial & Professional Regulation 2025

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The document is a Fingerprint Consent Form from the Illinois Department of Financial and Professional Regulation's Medical Cannabis Unit, required for applicants of Medical Cannabis Dispensing Organizations and Dispensary Agents. It outlines the need for a fingerprint-based criminal history background check as per state regulations, details the process for submitting fingerprints through licensed vendors, and includes privacy statements regarding the use and retention of fingerprint data. The form must be signed by the applicant to authorize the release of any existing criminal history information.

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How to use or fill out the Illinois Department of Financial & Professional Regulation Fingerprint Consent Form

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Click ‘Get Form’ to open it in the editor.
Begin by filling out the 'Facility Information' section. Enter the Requesting Agency ORI Identifier and Purpose Code as specified. Ensure that you provide the correct agency name and address for accurate processing.
Next, move to the 'Applicant Information' section. Fill in your full name, Social Security Number (SSN), maiden name, date of birth, gender, race, phone number, and driver's license or state ID number along with its issuing state.
In the 'Live Scan Vendor/Appointment Information' section, input the vendor's name and address. Also, include their phone number and your appointment date and time for fingerprinting.
Review the Privacy Statement carefully before proceeding. This section outlines how your information will be used.
Finally, sign and date the 'Applicant Consent' section to authorize the release of your criminal history record information.

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Versions	Form popularity	Fillable & printable
2018	4.8 Satisfied (62 Votes)
2015	4 Satisfied (45 Votes)

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How do I send my transcripts to Illinois State Board of education?

Have your regionally accredited institution send official* transcripts directly to ONE of the following addresses: transcripts@isbe.net. Illinois State Board of Education. Educator Effectiveness - E240. 100 N. 1st Street. Springfield, IL 62777. Regional Office of Education/Intermediate Service Center

How do I email the IDFPR in Illinois?

To contact IDFPRs ADA Coordinator George Cotton, please email FPR.EEO@illinois.gov.

How do I send my transcripts to the Illinois Department of Financial and professional Regulations?

- Transcripts can be uploaded as part of the online application system, sent by mail to the Departments Springfield office, or by email to: FPR.NurseUnit@illinois.gov o To provide Certification of Licensure (CT form) in other U.S. jurisdiction, visit Nursys.com and pay to have a Verification sent to Illinois.

How do I send my transcripts to BRN?

Electronic transcripts must be sent to brn.etranscripts@dca.ca.gov. If you attended a nursing program in another country, you will need to have your official transcripts sent to the Board by mail.

How do I renew my expired Perc card in Illinois?

If your original PERC has expired, contact the Divisions Call Center at 1-800-560-6420 and request a renewal. Please indicate any change of address on your renewal. If your PERC has been lost you can print your PERC on-line at .idfpr.illinois.gov by selecting the e-License Search link.

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What does the Illinois Department of Financial and Professional Regulation do?

The Illinois Department of Financial and Professional Regulation (IDFPR) licenses and regulates over 1 million individuals and organizations doing business in Illinois. The four divisions of IDFPR are Professional Regulation, Banking, Financial Institutions, and Real Estate.

How do I send my transcripts to Nasba?

Transcripts and degree certificates (diplomas) may be submitted electronically provided they are official. Some schools do not offer this service. Contact your Registrar or academic records office for additional information. If an email address is required for electronic delivery, use etranscriptnies@nasba.org.

How do I contact the Illinois Department of Financial and Professional Regulation?

Effective immediately, The IL Department of Financial and Professional Regulation (IDFPR) announced a new licensing contact number, 1-800-560-6420.

State of Illinois Department of Financial & Professional RegulationIllinois Department of Financial and Professional Regulation DivisionState of Illinois Department of Financial & Professional Regulation 2025

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How to use or fill out the Illinois Department of Financial & Professional Regulation Fingerprint Consent Form

See more State of Illinois Department of Financial & Professional RegulationIllinois Department of Financial and Professional Regulation DivisionState of Illinois Department of Financial & Professional Regulation versions

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How do I send my transcripts to Illinois State Board of education?

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How do I send my transcripts to the Illinois Department of Financial and professional Regulations?

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How do I renew my expired Perc card in Illinois?

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What does the Illinois Department of Financial and Professional Regulation do?

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