BCI Grant Contact

"*" indicates required fields

Agency Name*

Enter the name of your agency, company organization, entity, etc.

Agency Address*

There is where your fingerprint system will reside.

Address Line 1 Address Line 2 City State ZIP Code

County*

ORI*

Your FBI-assigned ORI. If you do not have an ORI, you are not eligible to operate an Ohio Law Enforcement or Judicial fingerprint system.

Primary Contact Name*

The primary organizer for the fingerprint system within your agency.

First Last

Primary Contact Phone #*

Primary Contact Email Address*

LSA/Technical Contact Name*

Live Scan Administrator or Technical contact; who we may contact for Support.

First Last

LSA/Technical Contact Phone #*

LSA/Technical Contact Email Address*

Billing Contact Name*

Person responsible for handling A/R or A/P for fingerprint system.

First Last

Billing Contact Phone #*

Billing Contact Email Address*

Billing Address (optional)

Check here if your billing address is the same as your agency address

Billing Address (if different than agency address)

It is only necessary to complete the billing address fields IF your billing address differs from your agency address.

Address Line 1 Address Line 2 City State ZIP Code