1. Fill out Form: Download the Fingerprint Authorization form unless you have been given a custom Authorization Form from your Employer.
   • It must have a valid ORI number issued for the provider company.
   • Complete the form with your personal information.
2. Find the closest Accurate Biometrics fingerprint location and its hours of operation by clicking here. No appointments necessary at any of our sites!
3. What to Bring: Bring the completed form, a valid, government issued, picture ID (such as a driver's license, State ID or passport). A receipt will be provided after fingerprinting that includes the name, date and Transaction Control Number (TCN).
4. You will be given a computer-generated receipt upon completion of the fingerprinting process.
5. The fingerprint technician will sign and date the form verifying fingerprinting by Accurate Biometrics.
6. Your results will be sent directly from the Illinois State Police to the Illinois Department of Public Aid.

*Price: The cost of fingerprinting is $67. We do not accept cash or personal checks. All Major credit cards and money orders are accepted. Click here to view complete list of payment terms.*

If you are interested in learning more about setting up an account for fingerprinting, please contact the Account Management Team at 773-685-5832 or email [email protected]

1. Applicants submitting their fingerprints from out-of-state, please download and print out the forms in the Out-of-State Forms Packet above. It contains an Illinois Out-of-State Fingerprint Authorization Form, an Identity Verification Certifying Statement, a credit card payment form, and the FBI FD-258 fingerprint card form. It is acceptable to print the FBI FD-258 form on standard white printer/copy paper. Please use back ink to fill out the forms.

2. Have two sets of fingerprints taken and placed on the FBI FD-258 card or printed form, using the ink and roll process.

   Note: We will also accept fingerprint cards created by printing on to the cards from an electronic capture by an authorized fingerprint provider such as a local law enforcement agency or licensed fingerprint contractor.

   • The card must be filled out completely at the time of fingerprinting.
   • Required information includes: full name, date of birth, home address, sex, height, weight, hair color, eye color, place of birth, reason fingerprinted, social security number, signature of official taking the prints, signature of person fingerprinted, date. A key to the correct code to use for sex, eye color and hair color can be found here.
   • In the ORI field, please write in the ORI number which is IL920600Z
   • The FBI field should remain blank.
   • ”Reason Fingerprinted” on the card should be “MMV” (the Illinois purpose code for Medicaid/Medicare Vendor).
   • Do not sign the card before fingerprinting! Both you and the fingerprinting agent will sign the card at the time of the fingerprinting.
3. The applicant only fills out Section 1 of the Identity Verification Certifying Statement (OOS-FP). Section 2 is filled out by the law enforcement or fingerprinting agent at the time of fingerprinting. The TCN field in this section will remain blank (to be completed by the livescan vendor). Section 3 is completed by the Accurate Biometrics technician.

4. The applicant should fill out the Illinois Out-of-State Fingerprinting/Consent Form.

   Please sign the form to acknowledge that you have read and agree to the data privacy and biometric information policy.

   You must include your phone number or email address in the event we need to contact you regarding your fingerprint card. If you include your email address, you will receive a receipt indicating the Transaction Control Number (TCN) for your submission. Please retain this receipt that includes your TCN number in case there are any follow up questions regarding your fingerprint submission.

5. Send the completed Illinois Out-of-State Fingerprinting/Consent Form, the Identity Verification Certifying statement, the fingerprint cards and payment of $67 (price includes ALL collection fees, state fees, and any local taxes, if applicable) by one of the following methods:
   • Money order or company check (NO CASH OR PERSONAL CHECKS) payable to Accurate Biometrics. Be sure to include the full name of the applicant on the money order or company check.
   • For credit card payments, fill out and include the Credit Card Payment Form.
   • Be sure to include the expiration date and 3 or 4 digit security code of the credit card that you are using.
6. Check to be sure to include the following items when mailing your fingerprint card for processing:
   • Completed FBI fingerprint card.
   • Completed Illinois Out-of-State Fingerprinting/Consent Form
   • Completed Identity Verification Certifying statement
   • Payment-Money Order, Company Check or Credit Card Payment Form (NO CASH OR PERSONAL CHECKS)
7. Mail To:
   • Accurate Biometrics – Medicaid Provider
   • 500 Park Blvd, Suite 1260
   • Itasca, IL 60143



8. Please Note: to protect the privacy of our applicants, we cannot send any forms containing personal information to anyone, including anything back to the applicant, even via email. THE APPLICANT SHOULD KEEP A COPY OF THEIR FORMS FOR THEIR RECORDS.