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STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES REQUEST FOR LIVE SCAN SERVICE Applicant Submission 1. ORI: (Check one) Code assigned by DOJ s 2. Type
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The LIC9163 form is a document used for reporting certain information to the licensing authority.
Those entities or individuals who are authorized or licensed by the licensing authority are required to file the LIC9163 form.
To fill out the LIC9163 form, you need to provide the required information in the designated fields of the form. This may include details about the entity or individual, specific transactions, financial information, or any other information as required by the licensing authority.
The purpose of the LIC9163 form is to gather important information from authorized or licensed entities or individuals. This information is then used by the licensing authority for various purposes such as regulatory compliance, monitoring, and enforcement.
The specific information that must be reported on the LIC9163 form may vary depending on the requirements of the licensing authority. Generally, it may include details about the entity or individual, financial information, transactions, licenses or authorizations held, and any other relevant information.
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