Instructions for Completing the Applicant Fingerprint Card

*Please either submit a completed fingerprint card to the Board office or submit your fingerprints electronically.*
*Please do not submit your fingerprints to be processed by mail and electronically.*

**Please do not email or mail fingerprint cards directly to the SBI, cards must be submitted to the NCBALB office or electronically from an NC law enforcement agency**

Fingerprint cards may be obtained from any local Police Department

The complete name of the subject is to be listed as indicated: last name, first name, and middle name. Please ensure the name is legible if written.
List any and all alias names or nicknames, maiden names, or any other married names.
Sex is to be listed as M for Male and F for Female or U for Unknown.
Race is to be listed by placing an individual into one (1) of the following categories by writing the appropriate letter in the space provided.
W – White
B – Black
I – American Indian or Alaskan Native
A – Asian or Pacific Islander
U – Unknown if unsure or unable to determine
Indicate the subject’s height in feet and inches using all numerical digits.
Example: 6’01” = 601, 6’11” = 611, 6′ = 600
Indicate the subject’s weight in pounds using all numerical digits.
Example: 186 or 098, etc.
List the subject’s eye color by placing one (1) of the following eye color codes in the space provided:
BLK -Black GRY-Gray MAR-Maroon
BLU-Blue GRN-Green PNK-Pink
BRO-Brown HAZ-Hazel XXX-Unknown
Color of hair should be indicated by writing one (1) of the following color codes in the space provided:
BAL- Bald (When subject has lost most of his or her hair or is hairless)
BLK- Black
BLN- Blond or Strawberry
BRO- Brown
GRY-Gray or partially
RED- Red or Auburn
SDY- Sandy
List the date of birth numerically – month, day and year.
Example: May 11, 1955 should be shown as 05111955
Indicate, if possible, the city and state where the subject was born. The state should be indicated by the two digit abbreviation.
OCA block: NCBALB000
Social Security: Write in the Social Security number.
Residence of Person Fingerprinted: Current residence of subject fingerprinted as written here.
Employer Address: NC Behavior Analyst Licensure Board, 701 Exposition Place, Ste 206, Raleigh, NC 27615
Reason Fingerprinted: NC BEHAVIOR ANALYST LICENSURE BOARD – STATE ONLY – NCGS 90-726.14

If mailing your fingerprint card please mail a completed card to the Board office:
NC Behavior Analyst Licensure Board
701 Exposition Place, Ste 206
Raleigh, NC 27615

Electronic Fingerprint Submission:
Electronic fingerprints (Livescan) are only accepted by North Carolina State Law Enforcement Agencies. Applicants must provide the Electronic Fingerprint Submission Release of Information and Application Information form. These forms can be found in the Livescan Reference Guide below.

Livescan Reference Guide

** The NC SBI does not accept electronic fingerprint submission from other states. The NC SBI only accepts electronic fingerprint submissions from NC Law Enforcement Agencies. If you are in another state, you must mail in the fingerprint card to the SBI for processing. **

Please ensure fingerprints submitted electronically or by mail include the following information along with all demographics:
Employer and Address field: NC BEHAVIOR ANALYST LICENSURE BOARD
Your number OCA: NCBALB000
Reason Fingerprinted: NC BEHAVIOR ANALYST LICENSURE BOARD – STATE ONLY – NCGS 90-726.14
For electronic purposes only submitted in NC: TOT-NFUF | NCT-OTH

Note: When mailing in your fingerprint cards please be sure to complete and upload an authority for release of information form to the application submission portal. The fingerprint cards cannot be submitted processing without this completed form.