CJIS Fingerprinting Supply Requisition Form

1-178 (Rev 07-01-2017)

Use this form for ordering supplies from the Criminal Justice Information Services Division

FD-249
Arrest and Institution Fingerprint Cards (white card with red ink) (2,000 cards per box)

Quantity of FD-249 Without ORI# Boxes

Quantity of FD-249 With ORI# Boxes

FD-258
Applicant Fingerprint Cards (white card with blue ink) (2,000 cards per box)

Quantity of FD-258 Without ORI# Boxes

Quantity of FD-258 With ORI# Boxes

Miscellaneous Cards and Forms

FD-353
Personal Identification Fingerprint Cards (white card with green ink) (2,000 cards per box)

Quantity of FD-353 Boxes

FD-884
Palm Prints (white card with red ink) (2,000 cards per box)

Quantity of FD-884 Boxes

FD-884a
Standard Supplemental Finger and Palm Print Cards (white card with red ink) (2,000 cards per box)

Quantity of FD-884a Boxes

Live Scan Card
Completely Blank (white card) (2,000 cards per box)

Quantity of Live Scan Cards Boxes

R-84
Final Disposition Report Form (4,000 per box)

Quantity of R-84 Boxes

I-12
Flash/Cancellation Notice (4,000 per box)

Quantity of I-12 Boxes

1-433a
Supervision Transfer Notice (100 per package)

Quantity of 1-433a Boxes

FD-1114
FBI Expungement (100 per package)

Quantity of FD-1114 Boxes

FD-1115
Records Modification (100 per package)

Quantity of FD-1115 Boxes

Envelopes (Federal Agencies Only)

FP-0001
Manila Envelopes, 9 ½" x 12"
Used in mailing print cards, forms & misc. items to the FBI Only (500 envelopes per box)

Quantity of Envelopes Boxes

Contact Info

ORI Number Must Be Furnished Even If You Are Ordering Blank Cards

Agency

Agency point of contact

Telephone Number

Shipping Address No P.O Boxes

City

State

Zip Code

Service Numbers: Questions may be directed to LSU at (304) 625-3983.

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