Michigan PDF Forms

Michigan PDF Forms

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Documents used along the form

The Michigan RI-030 form is a crucial document for individuals seeking a Live Scan fingerprint background check, specifically for Driver Education Providers and Instructors. However, several other forms and documents are often used in conjunction with the RI-030 to ensure a smooth and compliant process. Understanding these documents can help streamline your experience and ensure that all necessary information is provided. Below is a list of relevant documents that may accompany the RI-030 form.

  • Live Scan Operator Manual: This manual provides detailed instructions for Live Scan operators on how to process fingerprint submissions correctly. It ensures that operators understand the technical requirements and procedures involved in capturing and submitting fingerprints.
  • Background Check Authorization Form: This form is typically required to obtain consent from the individual being fingerprinted. It outlines the purpose of the background check and ensures that the applicant understands how their information will be used.
  • Identification Verification Form: This document is used to verify the identity of the applicant before fingerprinting. It usually requires a government-issued photo ID and may include additional personal information to confirm identity.
  • Agency Request Form: This form is filled out by the agency requesting the background check. It includes details such as the agency's name, ID, and the reason for the fingerprinting, ensuring that the request is properly documented.
  • Privacy Act Statement: This statement informs applicants about their rights regarding personal information and how it will be used during the background check process. It is essential for transparency and compliance with privacy laws.
  • Georgia WC 102B form: This essential document serves as a formal notice indicating that an attorney represents a party other than the claimant or employee in a workers' compensation case, ensuring that all parties are informed. For more details, refer to Forms Georgia.
  • Fingerprint Submission Receipt: After the fingerprinting process, the applicant receives a receipt confirming that their fingerprints have been submitted. This document serves as proof of submission and may be required for follow-up inquiries.
  • Applicant's Personal Information Sheet: This form collects demographic information from the applicant, such as their name, address, and date of birth. It is essential for accurately processing the background check and linking the fingerprints to the correct individual.

Being familiar with these accompanying documents can significantly enhance your understanding of the fingerprint background check process in Michigan. Ensuring that all forms are completed accurately and submitted in a timely manner will help facilitate a smoother experience. If you have any questions about these documents, consider reaching out to the relevant agency for clarification.

Michigan Ri 030 Preview

STATE OF MICHIGAN

DEPARTMENT OF STATE

LANSING

The following Live Scan Fingerprint Background Check Request (RI-030) form is ONLY to be used if you are either a Driver Education Provider Owner/Designated Representative or a Driver Education Instructor. This form should not be utilized by any other entities, fingerprint codes, or agencies.

Please ensure that the RI-030 has been filled out completely and properly prior to the scheduled appointment with the Live Scan Vendor for completion of fingerprints. In part one of the RI-030, Box one should be listed with the appropriate fingerprint code. For Driver Education Provider Owner/Designated Representative or a Driver Education Instructor, please utilize fingerprint code LDE. Boxes number two and three should read the agency ID, 3720E, and the agency name of MDOS Driver Education & Testing Section.

Fingerprint reason code LDE is pursuant to Michigan Complied Laws (MCL) 256.631(2), 256.641(4), 256.649, and 256.679.

O F F I C E O F I N V ES T I G A T I V E S ER V I C ES – D R I V ER E D U C A T I O N & T ES T I N G S EC T I O N

R I C H A R D H . A U S T I N B U I L D I N G 3 R D F L O O R 4 3 0 W . A L L E G A N L A N S I N G , M I C H I G A N 4 8 9 1 8

w w w . M i c hi g a n . go v / s o s (517) 241 - 6850

RI-030 (10/2020)

Michigan State Police

Page 1 of 2

AUTHORITY: MCL 28.162, MCL 28.214, MCL 28.248, & MCL 28.273

COMPLIANCE: Voluntary. However, failure to complete this form will result in denial of request.

LIVE SCAN FINGERPRINT BACKGROUND CHECK REQUEST

Purpose: To conduct a civil fingerprint-based background check for employment, to volunteer, or for licensing purposes as authorized by law.

Instructions: See page two.

I. Authorizing Information

1. Fingerprint Reason Code

2. Requestor/Agency ID

3. Agency Name

4. Individual ID (MNU-OA)

II.Applicant Information: Type or clearly print answers in all fields before going to be fingerprinted.

1a. Last Name

1b. First Name

1c. Middle Initial

1d. Suffix

2. Any Alternative Names, Last Names, or Aliases

3. Social Security Number (Optional)

DO NOT SUBMITT SSN

4. Place of Birth (State or Country)

5. Date of Birth

6. Phone Number

7. Driver's License / State ID Number

8. Issuing State

9. Home Address

10. City

11. State

12. ZIP Code

13. Sex

14. Race

15. Height

16. Weight

17. Eye Color

18. Hair Color

III. Live Scan Information

1. Date Printed

2. Picture ID Type Presented

3. Transaction Control Number (TCN)

4. Live Scan Operator*

*When an individual ID is provided, please enter the ID into the Miscellaneous Number (MNU) field on the Live Scan device. Select OA - Originating Agency Identifier and then enter the unique identifier in the Identification Code field.

IV. Privacy Act Statement

Authority: Acquisition, preservation, and exchange of fingerprints and associated information by the Federal Bureau of Investigation (FBI) is generally authorized under 28 U.S.C. 534. Depending on the nature of your application, supplemental authorities include Federal statutes, State statutes pursuant to Pub. L. 92-544, Presidential Executive Orders, and federal regulations. Providing your fingerprints and associated information is voluntary; however, failure to do so may affect completion or approval of your application. Principal Purpose: Certain determinations, such as employment, licensing, and security clearances, may be predicated on fingerprint- based background checks. Your fingerprints and associated information/biometrics may be provided to the employing, investigating, or otherwise responsible agency, and/or the FBI for the purpose of comparing your fingerprints to other fingerprints in the FBI's Next Generation Identification (NGI) system or its successor systems (including civil, criminal, and latent fingerprint repositories) or other available records of the employing, investigating, or otherwise responsible agency. The FBI may retain your fingerprints and associated information/biometrics in NGI after the completion of this application and, while retained, your fingerprints may continue to be compared against other fingerprints submitted to or retained by NGI.

Routine Uses: During the processing of this application and for as long thereafter as your fingerprints and associated information/biometrics are retained in NGI, your information may be disclosed pursuant to your consent, and may be disclosed without your consent as permitted by the Privacy Act of 1974 and all applicable Routine Uses as may be published at any time in the Federal Register, including the Routine Uses for the NGI system and the FBI's Blanket Routine Uses. Routine Uses include, but are not limited to, disclosures to: employing, governmental or authorized non-governmental agencies responsible for employment, contracting, licensing, security clearances, and other suitability determinations; local, state, tribal, or federal law enforcement agencies; criminal justice agencies; and agencies responsible for national security or public safety.

V. Procedure to Obtain a Change, Correction, or Update of Identification Records

If, after reviewing his/her identification record, the subject thereof believes that it is incorrect or incomplete in any respect and wishes changes, corrections, or updating of the alleged deficiency; he/she should make application directly to the agency which contributed the questioned information. The subject of a record may also direct his/her challenge as to the accuracy or completeness of any entry on his/her record to the FBI, Criminal Justice Information Services (CJIS) Division, ATTN: SCU, Mod. D2, 1000 Custer Hollow Road, Clarksburg, WV 26306. The FBI will then forward the challenge to the agency which submitted the data requesting that agency to verify or correct the challenged entry. Upon the receipt of an official communication directly from the agency which contributed the original information, the FBI CJIS Division will make any changes necessary in accordance with the information supplied by that agency. (28 CFR § 16.34)

VI. Consent

I understand that my personal information and biometric data being submitted by Live Scan, will be used to search against identification records from both the Michigan State Police (MSP) and the FBI for the purpose listed above. I hereby authorize the release of my personal information for such purposes and release of any records found to the authorized requesting agency listed above.

Signature:

Date:

RI-030 (10/2020)

Michigan State Police

Page 2 of 2

INSTRUCTIONS

Section I:

Authorizing Information:

This section is to be completed by the agency authorized to request civil fingerprint-based background checks.

1.Fingerprint Code:

The fingerprint code identifies the authorizing purpose in law allowing the agency to request the civil fingerprint-based background check. For example, School Employment (SE), Child Protection Volunteer (CPV), Health Care employment (HC).

2.Requesting Agency Identification (ID):

The requesting agency ID is assigned to your agency by the MSP. No request for fingerprinting can be completed without an agency ID. Please ensure the correct fingerprinting reason code and agency Identification is used. The MSP will charge for second requests due to incorrect codes.

3.Agency Name:

The agency name is the legal name of the authorized agency. For schools specifically, the agency name is the name recognized by the Michigan Department of Education.

4.Individual ID (MNU-OA)

The Individual ID is a unique identifier specific to the individual requested to submit fingerprints. An ID such as a state issued licensing number, a Personnel Identification Code (PIC) number, or other similar uniquely issued identifier/number.

Section II:

Applicant Information:

This section can be completed by the authorized agency, the individual, or as a joint effort by both. Section II specifically pertains to the demographic information needed in order to obtain the biometric data of the applicant and is a unique identifier specific to the applicant.

Section III:

Live Scan Information:

This section is required to be completed by the Live Scan vendor operator and must be completed at the time of fingerprinting. After fingerprinting, the applicant shall return this signed and completed document to the requesting agency. The Live Scan operator must return a completed copy of the form to the applicant.

Similar forms

  • Michigan RI-030 Form: This form is specifically designed for Driver Education Provider Owners/Designated Representatives and Driver Education Instructors to request a fingerprint background check. It requires specific identification and demographic information, similar to other background check forms.
  • Michigan RI-031 Form: This form is used for volunteers working with children. Like the RI-030, it collects personal information and requires a fingerprint background check, emphasizing the importance of safety in environments involving minors.
  • Michigan RI-032 Form: This form is for healthcare professionals seeking licensure. It shares similarities with the RI-030 in that it necessitates a fingerprint background check and includes sections for demographic data and identification codes.
  • Michigan RI-033 Form: This document is intended for individuals applying for a concealed pistol license. It parallels the RI-030 by requiring fingerprinting and personal information to ensure thorough background checks for public safety.
  • Michigan RI-034 Form: This form is utilized by individuals applying for a gaming license. Similar to the RI-030, it mandates fingerprinting and collects personal data to assess eligibility and suitability for licensing.
  • Michigan RI-035 Form: This form is for applicants seeking employment in schools. It shares the same purpose as the RI-030, which is to conduct background checks through fingerprinting, ensuring a safe environment for students.
  • California Power of Attorney Form: This important document allows an individual to designate someone else to make critical decisions on their behalf, crucial for future planning. For more information, visit legalpdf.org/.
  • Michigan RI-036 Form: This document is for professionals in the financial industry requiring background checks. Like the RI-030, it collects essential personal information and mandates fingerprinting to uphold industry standards and regulations.

Misconceptions

  • Misconception 1: The RI-030 form can be used by anyone for any purpose.
  • This is incorrect. The RI-030 form is specifically designed for Driver Education Provider Owners, Designated Representatives, and Driver Education Instructors. Other entities or individuals should not use this form.

  • Misconception 2: Filling out the RI-030 form is optional.
  • While the act of submitting fingerprints is voluntary, completing the RI-030 form is not. Failure to fill it out correctly will lead to a denial of the fingerprinting request.

  • Misconception 3: The fingerprint code is the same for everyone.
  • This is false. Different fingerprint codes correspond to various purposes. For those using the RI-030 form, the correct code is LDE, which stands for Driver Education.

  • Misconception 4: You can submit your Social Security Number on the form.
  • Actually, the form advises against submitting your Social Security Number. It is marked as optional and should not be included to protect your privacy.

  • Misconception 5: The agency ID is not important.
  • This is misleading. The agency ID is crucial for processing the fingerprinting request. Without the correct agency ID, the request cannot be completed.

  • Misconception 6: You can complete the Live Scan section of the form yourself.
  • This is not accurate. The Live Scan section must be filled out by the Live Scan vendor operator at the time of fingerprinting. It is essential for the proper processing of your application.

Detailed Instructions for Using Michigan Ri 030

Filling out the Michigan RI-030 form is an important step for Driver Education Providers and Instructors to complete a Live Scan Fingerprint Background Check. Ensuring that the form is filled out accurately will help avoid delays in processing. Follow these steps carefully to ensure that all required information is provided before your appointment with the Live Scan vendor.

  1. Complete Section I: Authorizing Information
    • In Box 1, enter the fingerprint reason code: LDE.
    • In Box 2, write the agency ID: 3720E.
    • In Box 3, input the agency name: MDOS Driver Education & Testing Section.
    • In Box 4, provide the individual ID (MNU-OA), which is a unique identifier for the applicant.
  2. Complete Section II: Applicant Information
    • Clearly print your last name, first name, middle initial, and suffix in Boxes 1a, 1b, 1c, and 1d.
    • List any alternative names, last names, or aliases in Box 2.
    • Optionally, provide your Social Security Number in Box 3 (do not submit SSN).
    • Fill in your place of birth (state or country) in Box 4.
    • Enter your date of birth in Box 5.
    • Provide your phone number in Box 6.
    • Fill in your Driver's License or State ID number in Box 7.
    • Indicate the issuing state in Box 8.
    • Complete your home address in Boxes 9 to 12 (street address, city, state, ZIP code).
    • Indicate your sex, race, height, weight, eye color, and hair color in Boxes 13 to 18.
  3. Complete Section III: Live Scan Information
    • Leave Box 1 blank; this will be filled out by the Live Scan vendor.
    • In Box 2, provide the type of picture ID you presented.
    • Box 3 will also be filled out by the Live Scan vendor; leave it blank for now.
    • Box 4 will be completed by the Live Scan operator; ensure they enter your individual ID in the Miscellaneous Number (MNU) field.
  4. Review and Sign
    • Carefully review all information for accuracy.
    • Sign and date the form at the bottom to authorize the release of your personal information.

After completing the form, take it with you to your Live Scan appointment. The vendor will complete the necessary sections and return a copy to you. Be sure to keep this copy for your records and submit the original to the requesting agency.

Dos and Don'ts

Things You Should Do:

  • Fill out the RI-030 form completely and accurately before your appointment.
  • Use the correct fingerprint code, which is LDE for Driver Education Provider Owner/Designated Representative or Instructor.
  • Provide the agency ID (3720E) and agency name (MDOS Driver Education & Testing Section) in the appropriate boxes.
  • Clearly print all answers in the applicant information section to avoid any confusion.

Things You Shouldn't Do:

  • Do not submit your Social Security Number; it is optional and not required.
  • Do not leave any fields blank; incomplete forms may lead to denial of your request.
  • Do not use this form if you are not a Driver Education Provider Owner/Designated Representative or Instructor.
  • Do not forget to return the signed form to the requesting agency after fingerprinting.