Personal
Information: |
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Application
Type (required
field) |
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Click on the arrow to
the right of the words, Select an Item, and a drop down menu will appear. Click
on the application type for the license. |
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First Name
(required
field) |
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- Enter the
requester's first name. |
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Last
Name
(required
field) |
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- Enter the
requester's last name. |
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Address
(required
field) |
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- Enter the
requester's mailing address. |
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City
(required
field) |
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- Enter the city
of the requester's mailing
address. |
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State
(required
field) |
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The form will default to
Maryland as the state for the requester's mailing address. If the requester
is located in a state
other than Maryland, click on the arrow to
the right of the word, Maryland, and a drop down menu will appear. Click
on the state of the requester's mailing address. |
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Zip Code
(required
field) |
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- Enter the five-digit
or nine-digit zip code of the requester's mailing address. |
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Telephone
(required
field) |
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- Enter the telephone
number where the requester can be reached during the day, including area code.
Enter the phone number with dashes, like this 410-555-1212. Please
do not use parentheses. |
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Extension
(optional
field) |
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- Enter the extension
number for the requester's telephone number, if applicable. |
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E-mail
(required
field) |
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- Enter the
requester's e-mail address. |
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Order
Details: |
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Number of Fingerprint Cards (required
field) |
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The form will default to a quantity of one (1) fingerprint card. If you wish to order more than one
fingerprint card, please enter the number in this field. |
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Click on
Submit and an e-mail message
containing all the information that you entered will be sent to the Division
of Financial Regulation. You
will receive a confirmation e-mail including the details entered
on this form. |