DO NOT RETURN TO THE TEXAS

BOARD OF LAW EXAMINERS

To schedule an individual appointment, visit www.L1enrollment.com or call 1-888-467-2080

Authorized Agency Information

Agency ORI:

TX920370Z

Reason for fingerprinting:

Texas Bar Admission

Agency Name:

Texas Board of Law Examiners

Original TCN:

___________________________________________
(if resubmission for rejected prints)

Information to be Completed by Person Being Fingerprinted

Last Name:

_________________

First Name:

____________________

Middle Name: _________________

(please print)

Sex:

____Male

_____Female

Race:_________

[Enter One: W, B, A, I, or O.]

(W [includes Caucasian, Mexican, Latin, Puerto Rican, Cuban, Central/South American, and other Spanish Culture or origin, regardless of race] B [includes African American
and African] A, [includes Pacific Islander, Chinese, Japanese, Polynesian, Korean, and Vietnamese] I [includes Alaskan native, Eskimo, and American Indian] O [includes
all other races not listed])

Date of Birth:

_____________

Height:

___________

Weight:

___________

Hair Color:

__________

Eye Color: _________

(feet and inches)

Place of Birth:

__________________

Citizenship:

_________________

(state or country)

Social Security No.: __________________________

(country)

DL / ID No.: _______________________________________

State Issuing DL / ID No.: ________________________________

Home Address:
_______________________________________________________________________________________________
Street Address

City

State

Zip

Service Center Information (To be completed by Live Scan Operator)

Date Prints Taken:

Amount Charged For Service:

_______________________

________________________________

Note: Payment by credit card is available only for individual appointments at an L-1 facility, not at group processing sessions.

Paid by: ___ Check

___ Money Order

___ Visa

___ At time of scheduling

___ MasterCard

___ Billing Acct: ________________

___ At time of appointment

TCN
____________________________________________________________________________________________
_____ I HAVE COMPARED THE GOVERNMENT-ISSUED IDENTIFICATION PRESENTED BY THE APPLICANT AND
ATTEST THAT TO MY BEST DETERMINATION, I HAVE FINGERPRINTED THE SAME PERSON.
Name of LSO:

_____________________________________________________________________________________________________
(please print)

Signature of LSO:

____________________________________________________________________________________________________

FAST form/instructions.pdf (1/09)

SPECIAL INSTRUCTIONS FOR MAKING INDIVIDUAL APPOINTMENTS FOR FINGERPRINTING ON L-1 WEBSITE

Until such time as the website has been modified:

For the reason being fingerprinted, select All Others.

For the option selection, select Option A-Electronic Submission.

When prompted to respond to the following:
State Background Check Respond Yes.
Federal Background Check Respond Yes.
Are you being fingerprinted for a volunteer position? Respond No.

FAST form/instructions.pdf (1/09)

ii