Arkansas State Board of Nursin: TTRVERSIY TOWER AULD, SUTE 66D LTTLEROCK ARKANSAS azoefe19 ‘ahora 506202701 + Facsine $019082714 vntain or ARKANSAS and FBI CRIMINAL BACKGROUND CHECK INSTRUCTIONS. GENERAL INFORMATION ‘+ Arkansas law requires criminal background cheeks. + State and federal criminal background check i required if they are not already on file with Arkansos State Board ‘of Nursing (ASBN) within the last 12 months of application. “+ Background checks fom other agencies ae not accepted. “+ Fees astocated with conduction ofthe state and federal criminal background checks are at the applicant's ‘expense and are paid within the orline system. A fee of $35.00, in addition toa processing fee, is required to process the state and federal criminal background checks. FEES ARE NONREFUNDABLE. DO NOT, UNDER ANY CIRCUMSTANCES, CONTACT THE ARKANSAS STATE POLICE OR THE £1 ABOUT THE STATUS OF YOUR CRIMINAL BACKGROUND CHECKS. [ARKANSAS STATUTE fan appieant hes pleaded guy or nolo cantendere to o found guilty af any oense listed in ACA §37-07-922, he/she snot eigibe for Arkansas censure. (ACA § 17-87-312 provides the applicant an opportunity to request a walver of cligiity criteria related toa criminal background in certain cumstances), [ARKANSAS STATE POLICE CRIMINAL BACKGROUND CHECK The State Criminal Background Check information is abtained within the online application process; no addtional form i competed or submitted to Arkansas State Board of Nursing or the Arkansas State Police, FEDERAL CRIMINAL BACKGROUND CHECK The Federal Criminal Background Check requires that your fingerprints are used to check the criminal history record of the Federal Sureau of Investigation (FB) Fingerprint information i obtained in one of two ways, elther by Arkansas Live ‘Scan fingerprint scanning or Ik based fingerprint card. Refer tothe respective instructions contained here‘Arkansas State Board of Nursing Federal Criminal Background Check ‘arkansas ve Scan Fingerprint canning instructions ‘SBN has approved Arkansas Live Scan asthe ONLY vender for our agency tat can conc dal scanning of figerprint for Federal Criminal Beckground Checks. Obtaining gerprnts va Arkansas Liv Sean snot mandatory. However, is & wonderful option with significant benefits such as: Considerably fsterretun of results typical within a week as compared to 4-6 weeks or longer with nk based ‘fingerprinting: ‘+ High quality rgerprints ensure accuracy and minimize mistakes; and ‘+ Effcientimages with no messy nk proces; no Fingerprint cards requlred. ‘Approved Company: Arkansas Live Scan ‘CONTACT INFORMATION. 1. Website 2. Emil Prntst@ arkansas veScan com 3. Phone: 888.292.8211 DislEXTS 4. Lie Sean Administrator Direct Number: 479.459.6899, Location Addrestes 1. 1402 Arapaho, Springdale, AR 72764 (Inside Farmers insurance Bulding) 23811 Rogers Ave, Suite C Fort Smith, AR 72903 53. 1920. Main St, Suite 101, North ite Rock, AR 72216 4. The mobile units avaliable fr onsite testing, Reserved for groups greater then 25 students, but request can be handled on incividual bas, so call" Depencing upon customer needs and dering Arkanas ive Scan will accommodate request of service ouside normal business hours when needed, INSTRUCTIONS In order to have fingerprint obtained va Arkansas Live Scan nat the following: 4. Submit application ‘Licensure Examination or Endorsement applicants should submit an ASB application via acestng the Online Application Sytem at yasu.asha.arz under Online Sevies. Pay the respective application, criminal ‘background eheck (CBC) and temporary permit (8s applicable) fees and print the payment summary, ‘+ Fan indivgua snot submitting an electronic Nensure application or dl nat request and pay the CBC fee wien submitting an application, request completion of CBC by acessng the "Ciminl Background Checks nd Fingerprint Card Request System?” at wr. acbn 2 under the Forms Tb, Under Other Online Services| Click the link “criminal Background Checks ond Fingerprint Card Request Sytem”. Pay the respective criminal background checkfe and print the payment summary. Fllw remainig structions 2. Obtain fingerprints + Each applicant must take the Payment Summary form reflecting payment of CBC fee) and photo 1D tothe she (no fingerprint cardi needed} + Theres an additonal $5.00 fe that each applicant pays to Arkansas Live Scan when having alive sean conducted. FEES ARE NONREFUNDABLE ‘+The applicant and fingerprint technician wil complete a Harvester Fingerprint Form. ‘+ rkansa Uve ean wil electrically submit the Harvester Fingerprint arm to ASBN. 4+ Atkansas Lie Sean electroncaly submits fingerprints. ‘Aoplicants may check the status Ink at ars. O° fr any communications Yom ASBN, End of Arkansat Uve Scan Fingerprint Scanning instructions Atos Ste Bord of Musing fege2sArkansas State Board of Nursing Federal Criminal Background Check Arkansas Ink Based Fingerprint Cad instructions InstRUCTIONS ‘Tohave your fingerprints obtained via the nk based option you MUST use the fingrpcir card provided by the ASBN. Legly complete the fingerprint card accurately and follow detald instructions identified hereh. An incomplete card wil delay processing. ASBN typcly receWves results in 4-6 weeks: at mest may be longer. 1 Submit application ‘+ Leensure Examination or Endorsement applicants should submit an ASB application va acesting the Online Applaton System at wiv.astn, a under Online Services. Pa the respective application, criminal background check and temporary permit (as appzable)fes and pint he payment summary. ‘+ tfanindivdual snot submitting an electronic censure application or dd not request and pay the Criminal Background Check fee when submitting an appliation, request completion ofthe Criminal Badground ‘Checks by acessng the “Criminal Background Check an Fingerprint ard Request Syste” at swt acbn.oe under the Forms Tab. Under Othe Onin Services clekthe lnk “Criminal Background Checks and Fingerprint Card Request System. ay the respective criminal background check fee and pint the payment summary Follow reining intrctons 2. Obtain the fingerprint card * Ucensure Examination (NCLEX*) applicants who ae recent graduates fom an Arkansas nursing education program must obtain the fingerprint card from the nursing education program. + Note: fyou ore nota recent graduate, you MUST request that a fingerprint cards sent to you by mai since the fingerprint card wil nt be automatically mold. To request ofngeroint cord click onthe especie link ‘within the online system. + DONOT ENO OR FOLD THE FINGERPRINT CARD, 3 Camp ogni ard Legibly complete the fingerprint card accurately and follow instructions identified herein. An incomplete card wil delay processing. BE SURE ALL BOXES ARE COMPLETED PER INSTRUCTIONS. ‘+The Fingerprint Card CANNOT be submited to the Arkansas State Police before completion of the onine appleatin. Theres a specie INA Search ID number tha s made avaiable to an applicant on the Payment Summary page + The ‘ollowing boxes MUST be completed onthe fingerpint card (typeor pint, black nk only) Refer to crarpleof completed fingerprint cad ‘Lastname, st name, mide name 4 signature of person fingerprinted 1 Alases other names you have use Including nihnames, maiden name, other mated names, et} of (enould reac: ARG 208902 state Board oF Nursing Lie Rock, A) ate of bth (ureric month, numer day, numeri ves) 1 Residence of person fingerprinted sree addres of port ofie box, cy, tte) 1+ Giizenship .e, United Sates, England, Philppines) + Sax rae, height, weight yes clo), hal (sor Sex: M=Mal; Female Race: Axkian; W=Whie: Balac;IrAmercan naan; UsUnknown; (i Hispanic use W") Eyes: BLU=Biue; ORO Brown; BLKeBack al MaReMaroon PNKPink;XXX*Unknown Hal: B= ay; WHl=Mhite;BLN=Slond;REDeRadXXK=Unknown 1 Place of ith (ty, tte, or orelgn country) + Employer and adress ("none you are unemployed) ‘Reason fingerprinted {Should read Aransas tate Boats of Nursing ACA§27.97-312) + Soci Security number ‘Fol eave lank: rint he INA Seszeh 1D number inthe upper righthand corner ofthe fingerprint card + Leaveal other spaces bank (OCA, MNU, HNL) ‘fan indvualis missing one or more fgets, a notation nthe gern block) nesting why 2 partis ‘ce miting image exists most be writen im. Handurtten notations recommended for fngeprint ‘Submision nude: Amp (amputated) Tharp (vp amputated, Ming sth, Cut, shot, Deformed and Mesng sonar Soe Bord of Mig pages