Order FL-APP

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Agency Information

Agency Name*

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

Agency Address*

There is where we will ship your fingerprint system.

Address Line 1 Address Line 2 City State ZIP Code

County*

Device TCN Prefix*

Your 5-to-7-digit Device Transaction Control Number (TCN) prefix provided by FDLE. If you do not yet have a Device TCN prefix from FDLE, please check the box below.

Device Registration ID*

Your 9-digit Device Registration ID provided by FDLE. If you do not yet have a Device Registration ID from FDLE, please check the box below.

No FDLE LiveScan Device Registration Form

I do not yet have an FDLE Device TCN Prefix or Device Registration ID

You must apply for and provide your FDLE LiveScan Device Registration Form to BIM before we can deliver your fingerprint system.

Contact Information

Primary Contact Name*

The primary buyer or 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 the 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

Purchase Information

Are you tax exempt?*

If you answer YES for your agency, you must submit your Florida Sales Tax Exemption Certificate to accounting@bioinfomgt.com.

Would you prefer to purchase a laptop or desktop computer with your BIM Fingerprint System?*

You must purchase a new computer from BIM for your new BIM fingerprint system. Please choose either a Laptop or Desktop computer that BIM will provide.

Would you like to purchase any of these optional add-ons?

Roller Case

Additional 12 months of Support

Adding one or more of these optional additions will increase the price of your system purchase, which will be reflected on your invoice. Please refer to your quote for pricing.

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Florida Applicant Fingerprint System Order Form

Sales Contact

Larger Orders

Agency Information

Contact Information

Purchase Information