Form 41-LS Request for Live Scan Service. Form 41-LS Request for Live Scan Service Rev. 06/09 - ctc ca 2025

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The document is a request form for Live Scan service, specifically for applicants seeking a teacher credential in California. It includes sections for applicant information, agency details, and criminal history checks by the DOJ and FBI. Required fields include personal identification details such as name, address, social security number, and physical characteristics.

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Click ‘Get Form’ to open it in the editor.
Begin with Section 1, where you will enter the Type of Application. Fill in the License/Certification/Permit Code assigned by DOJ and specify the Job Title or Type of License, Certification, or Permit.
In Section 2, provide the Agency Address and Contact Name. Ensure that all mandatory fields are filled accurately to avoid delays.
Proceed to Section 3. Here, input the Applicant's Name, Alias (if any), Driver’s License Number, Date of Birth, Sex, Height, Weight, Home Address, Eye Color, Hair Color, Place of Birth, Social Security Number (or ITIN), and OCA Number. All fields marked with an asterisk (*) are required.
In Section 4, select the Level of Service and if applicable, list the Original ATI Number for resubmissions.
Complete Section 5 by entering details about the Supplemental Agency/Employer including Employer Name and Mail Code.
Finally, fill out Section 6 with information about the Live Scan Operator and ensure all necessary copies are noted as per instructions.

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Versions	Form popularity	Fillable & printable
2015	4.8 Satisfied (106 Votes)
2013	4.1 Satisfied (31 Votes)
2011	4.3 Satisfied (48 Votes)
2010	4 Satisfied (53 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do I know if I passed my Live Scan?

Visit the California Department of Justice (DOJ) Applicant Background Check Status page. You will need your ATI number (Automated Transaction Identifier) and your date of birth to check the status. The status will indicate whether your Live Scan results are still pending or have been completed.

What disqualifies you from a Live Scan?

An individual convicted of any crime other than minor traffic violations is disqualified unless the California Department of Social Services (CDSS) grants an exemption from the clearance requirement.

Where to submit form 41 LS?

1) Take a copy of the Livescan 41-LS form to a Live Scan station to have your fingerprints taken. Your fingerprints will be electronically forwarded to the Commission. Keep a copy for your records. 2) Go to the California Commission on Teacher Credentialing online at .

How long does CTC take to clear a credential?

Use Form 41-NC Request to Change Name or Personal Profile on the Commissions website when there is a need to submit a name change (including when names are misspelled or reversed) or to change an SSN, ITIN or DOB.

What is the new Live Scan law in California?

Effective, January 1, 2022, all administrators, employees and all volunteers in California MUST have a one-time background check as approved by the California Department of Justice to exclude individuals with a history of child abuse. This form of background check requires live scan fingerprinting.