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For initial screening applications live scan fingerprints must be completed through DCFS. List of locations may be found at http //hslic.utah. gov/ Applicant Signature Date Program Name Crossroads Youth Services Inc. Primary Provider and Licensor Name For Office of Licensing Use Only FBI Date DHS/Office of Licensing Screening Approval Date FBI is Ongoing Rap Back Subscription YES NO Applicant First Name Middle Name Last Name Last 4 SSN 7. Fingerprints Fees For placement of a child IN CUSTODY...
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