Rev. August 2024 Page 3 of 7
Specialized Basic POST course completion certificate, or the federal equivalent thereof; or a copy of your POST profile
detailing completion of the Basic or Specialized Basic training which includes Power to Arrest training, or the federal
equivalent thereof. See BSIS website at
www.bsis.ca.gov for additional information regarding peace officer exemptions.
• Exemption from Fingerprint Submission Requirement: If you are a California peace officer as specified above and
are seeking an exemption from the fingerprint requirement, you must provide proof of your current sworn status.
Verification of your active duty status can be satisfied by providing the Bureau a legible copy of the front and back of
your peace officer identification card. This exemption does not apply if you are also applying for a BSIS Firearms Permit.
NOTE: If you apply for a Security Guard registration using the Live Scan exemption, you must report any change
in your active duty status to the Bureau within 72 hours of the change (BPC 7583.9). Failure to do so could result
in disciplinary action against your registration.
APPLICATION FOR SECURITY GUARD REGISTRATION
Mandatory Disclosure Language
Submission of the requested information is required unless otherwise noted as optional. The Bureau of Security
and Investigative Services (BSIS) of the Department of Consumer Affairs (Department) cannot process your
Security Guard Registration Initial Application unless all required information is provided. Your fingerprints will be
used to check the criminal history records of the FBI. You have the opportunity to complete or challenge the
accuracy of the information contained in the FBI identification record. The procedures for obtaining a change,
correction, or updating an FBI identification record are set forth in Title 28, Code of Federal Regulations (CFR)
Section 16.34. Procedures for obtaining a copy of the FBI criminal history record are set forth at Title 28, CFR
Section 16.30 through 16.33, which you can view by visiting
https://
www.edo.cjis.gov.
Pursuant to the Information Practices Act, the BSIS is responsible for maintaining the information in this application.
You have the right to review the records maintained on you by the BSIS or Department unless the records are
exempt from disclosure by section 1798.40 of the Civil Code. Your completed application becomes the property of
the BSIS and will be used by authorized personnel to determine your eligibility for a security guard registration.
Information on your application may be transferred to other governmental or law enforcement agencies, as
permitted by law.
Pursuant to the California Public Records Act (Gov. Code § 7920.000; et seq.) and the Information Practices Act
(Civ. Code § 1798.61), information about persons possessing a license, certificate, permit or registration may be
disclosed by the BSIS unless otherwise specifically exempt from disclosure under the law. The Address of Record
of each licensee is not exempt from disclosure and will be released upon request by a member of the public. The
BSIS makes every effort to protect the exempt personal information you provide us. Exempt information provided
by you, however, may be disclosed in response to a court or administrative order, a subpoena, or a search warrant.
Pursuant to Business and Professions Code section 30, providing your social security number is mandatory and
will be used primarily for tax enforcement purposes and for compliance with any judgment or order for family support
in accordance with section 17520 of the Family Code. If you fail to provide your social security number, you will be
reported to the Franchise Tax Board (FTB), which may assess a penalty against you. Further, pursuant to section
30, subdivision (m), your social security number together with your name, date of birth, and license information
may be shared with the Office of the Chancellor of the California Community Colleges. The Bureau is legally
prohibited from processing your application if you fail to provide your social security number or individual taxpayer
identification number.
The State Board of Equalization (BOE) and the FTB may share taxpayer information with the BSIS. You are
required to pay your state tax obligation. This application may be denied, or your license may be suspended if the
state tax obligation is not paid and your name appears on either the BOE or FTB certified list of top 500 tax
delinquencies.
For questions about this disclosure or access to your record, you may contact the BSIS by mail at Bureau of
Security and Investigative Services, Attn: Custodian of Record, P.O. Box 980550, Sacramento, CA 95798-0550;
For questions about the Department’s
Privacy Policy, you may contact the Department of Consumer Affairs by mail at 1625 North Market Boulevard,
I DECLARE UNDER PENALTY OF PERJURY, UNDER THE LAWS OF THE STATE OF CALIFORNIA, THAT:
• I personally completed this application;
• To the best of my knowledge all statements on this application are true and correct;
• I completed the 3-hour Power to Arrest and 5-hour Appropriate Use of Force training courses required for
a BSIS security guard registration or am an active duty peace officer who has successfully completed a
power to arrest course and the Appropriate Use of Force training course; and
• With full knowledge that all statements herein are subject to investigation and that any false or dishonest