FD-249 Criminal Fingerprint Card

LEAVE BLANK

(STAPLE HERE)

CRIMINAL

LEAVE BLANK

STATE USAGE
NFF SECOND

FD-249
(Rev.11-1-20)
5-15-17)
FD-249 (Rev.

1110-0046

SUBMISSION

APPROXIMATE CLASS

STATE USAGE

AMPUTATION

SCAR

LAST NAME, FIRST NAME, MIDDLE NAME, SUFFIX

SIGNATURE OF PERSON FINGERPRINTED

SOCIAL SECURITY NO.

LEAVE BLANK

ALIASES/MAIDEN
LAST NAME, FIRST NAME, MIDDLE NAME, SUFFIX

UNIVERSAL CONTROL NO.

R. THUMB

6. L THUMB

STATE IDENTIFICATION NO.

DATE OF BIRTH

2. R. INDEX

3. R. MIDDLE

4. R. RING

5. R. LITTLE

7. L. INDEX

8. L. MIDDLE

9. L. RING

10. L. LITTLE

LEFT FOUR FINGERS TAKEN SIMULTANEOUSLY

L. THUMB

MM

DD

R. THUMB

YY

SEX
SE
X

RACE

HEIGHT

WEIGHT

RIGHT FOUR FINGERS TAKEN SIMULTANEOUSLY

EYES

HAIR

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

The FBI's acquisition, preservation, and exchange of identification information is generally authorized under 28 USC 534. This FD-249 is to be used for criminal justice purposes, such as incident to arrests and
This FD-249 is to
beApplicant
used for criminal
justicecontains
purposes,
such as incident
to arrests
and Act
incarcerations.
incarcerations.
The
form (FD-258)
applicable
Paperwork
Reduction
and Privacy Act notices and should be used for noncriminal justice purposes. “A Social Security Account Number (SSAN)
is helpful 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), any Federal, State, or local government ______________
agency which
The Applicant
form (FD-258)
contains
applicable
Act and
Privacywhether
Act notices
and should
be used or
forvoluntary,
noncriminal
purposes.
requests
an individual
to disclose
his/her
SSAN isPaperwork
responsibleReduction
for informing
the person
disclosure
is mandatory
by justice
what statutory
or other authority the SSAN is solicited, and
what uses will be made of it..”
____________________________
JUVENILE FINGERPRINT

ORI

DAT E O F A R R E S T

SUBMISSION

YES

T R E AT A S A D U LT

YES

MM

DD

YY

C O N T R I B U TO R
ADDRESS
R E P LY

YES

DESIRED?
S E N D C O P Y TO :

DAT E O F O F F E N S E

(ENTER ORI)

MM

MISCELLANEOUS NUMBERS

O F F I C I A L TA K I N G F I N G E R P R I N T S

P L AC E O F B I RT H ( S TAT E O R C O U N T RY )
DD

C O U N T RY O F C I T I Z E N S H I P

YY

S C A R S , M A R K S , TAT TO O S , A N D A M P U TAT I O N S

RESIDENCE/COMPLETE ADDRESS

CITY

S TAT E

L O C A L I D E N T I F I C AT I O N / R E F E R E N C E

P H OTO AVA I L A B L E ?

YES

PA L M P R I N T S TA K E N ?

YES

(NAME OR NUMBER)

E M P L OY E R :

I F U. S . G OV E R N M E N T, I N D I C AT E S P E C I F I C AG E N C Y.

O C C U PAT I O N

I F M I L I TA RY, L I S T B R A N C H O F S E RV I C E A N D S E R I A L N O.

C H A R G E / C I TAT I O N
1.

DISPOSITION
1.

2.

2.

3.

3.

ADDITIONAL

ADDITIONAL

A D D I T I O N A L I N F O R M AT I O N / B A S I S F O R C AU T I O N

S TAT E B U R E AU S TA M P