FD-353 Personal Identification Card

PERSONAL IDENTIFICATION

TYPE OR PRINT ALL INFORMATION IN BLACK
LAST NAME

NAM

LEAVE BLANK

FBI

MIDDLE NAME

FIRST NAME

SEE REVERSE SIDE FOR FURTHER INSTRUCTIONS
FD-353 (Rev. 3-1-10) 1110-0046
SIGNATURE OF PERSON FINGERPRINTED

FINGERPRINTS SUBMITTED BY

DATE OF BIRTH DOB
Month
Day
Year

RESIDENCE OF PERSON FINGERPRINTED

SEX

DATE FINGERPRINTED

RACE

HGT.

WGT.

EYES

HAIR

PLACE OF BIRTH

PERSON TO BE NOTIFIED IN CASE OF EMERGENCY
NAME

LEAVE BLANK

SOCIAL SECURITY NO.

ADDRESS

CLASS

MISCELLANEOUS NO.

FINGERPRINTED BY
REF.
SCARS AND MARKS

1. R. THUMB

6.L. THUMB

2. R. INDEX

7. L. INDEX

LEFT FOUR FINGERSTAKEN SIMULTANEOUSLY

3. R. MIDDLE

4. R. RING

8. L. MIDDLE

9. L. RING

L. THUMB

R. THUMB

5. R. LITTLE

10. L. LITTLE

RIGHT FOUR FINGERS TAKEN SIMULTANEOUSLY

POB

FEDERAL BUREAU OF INVESTIGATION
UNITED STATES DEPARTMENT OF JUSTICE
CRIMINAL JUSTICE INFORMATION SERVICES DIVISION, CLARKSBURG, WV 26306

PERSONAL IDENTIFICATION
To obtain classifiable fingerprints:
1. Use printer’s ink.
2. Distribute ink evenly on inking slab.
3. Wash and dry fingers thoroughly.
4. Roll fingers from nail to nail, and avoid allowing fingers to slip.
5. Be sure impressions are recorded in correct order.
6. Notate in the appropriate finger blocks if applicant is missing one or more fingers for any reason. If not missing, all ten impressions must
be provided with scars and deformities notated.
7. If some physical condition makes it impossible to obtain perfect impressions, submit the best that can be obtained.
8. Examine the completed prints to see if they can be classified, bearing in mind the following:
Most fingerprints fall into the patterns shown below. Other patterns occur infrequently and are not shown here.

FD-353 Personal Identification Privacy Act Statement
Authority: The FBI's acquisition, preservation, and exchange of information requested
PASTE
PHOTO HERE
(OPTIONAL)

by this form is generally authorized under 28 U.S.C. 534. Supplemental authorities
include numerous Federal statutes, hundreds of State statutes pursuant to Pub.L. 92544, Presidential executive orders, regulations and/or orders of the Attorney General
of the United States, or other authorized authorities. Examples include, but are not
limited to: 5 U.S.C. 9101; Pub.L. 94-29; Pub.L. 101-604; and Executive Orders 10450
and 12968. Providing the requested information is voluntary; however, failure to furnish
the information may affect timely acceptance of your submission.

Social Security Account Number (SSAN). Your SSAN is needed to keep records
accurate because other people may have the same name and birth date. Pursuant to
the Federal Privacy Act of 1974 (5 USC 552a), the requesting agency is responsible
for informing you whether disclosure is mandatory or voluntary, by what statutory or
other authority your SSAN is solicited, and what uses will be made of it. Executive
Order 9397 also asks Federal agencies to use this number to help identify individuals
in agency records. Providing of the SSAN is voluntary.

Principal Purpose: Your fingerprints and other information contained on this form
may be submitted to the FBI for identification purposes. The FBI may also retain the
submitted information in the FBI's collection of fingerprints and related information
against which other fingerprint submissions may be compared.

Routine Uses: The fingerprints and information reported on this form may be disclosed
pursuant to your consent, and may also be disclosed by the FBI without your consent
as permitted by the Federal Privacy Act of 1974 (5 USC 552a(b)) and all applicable
routine uses as may be published at any time in the Federal Register, including the
routine uses for the FBI Fingerprint Identification Records System (Justice/FBI-009)
and the FBI's Blanket Routine Uses (Justice/FBI-BRU). Routine uses include, but are
not limited to, disclosures to: appropriate governmental authorities responsible for civil
or criminal law enforcement, counterintelligence, national security or public safety
matters to which the information may be relevant.
FD-353 (Rev. 3-1-10)