W9127822Q0006 Solicitation-Attachment_2_Sample_Fingerprint_Card.pdf

SF 87 (REV. DECEMBER

2017) US OFFICE OF

PERSONNEL

MANAGEMENT

E.O. 10450

SIGNATURE OF PERSON FINGERPRINTED

RESIDENCE OF PERSON FINGERPRINTED

LEAVE BLANK

R I s N

TYPE OR PRINT ALL INFORMATION IN BLACK EBI

LAST NAME NAM FIRST NAME MIDDLE NAME LEAVE BLANK

I SERIAL NO. (OPM USE ONLY) OCA

I~ l'PAC MISCELLANEOUS NO. MNU DATE OF BIRTH DOB

MONTH DAY

ALIASES AKA SEX I RACE ti GT. I ',<YGT. I EYES I HAIR PLACE OF BIRTH POB

DATE I SIGNATURE OF OFFICIAL TAKING FINGERPRINTS

LEAVE BLANK

TITLE AND.ADDRESS SCARS, MARKS, AND TATTOOS

CLASS

POSITION TO WHICH APPOINTED FBI NO. EB!

REF.

DEPARTMENT, BUREAU, AND DUTY STATION (CITY AND STATE) SOCIAL SECURITY NO. SOC

1. R. THUMB 2. R. INDEX 3. R. MIDDLE 4. R. RING 5. R. LITTLE

6. L. THUMB 7. L. INDEX 8. L. MIDDDLE 9. L. RING 10. L. LITTLE

LEFT FOUR FINGERS TAKEN SIMULTANEOUSLY L. THUMB R. THUMB RIGHT FOUR FINGERS TAKEN SIMULTANEOUSLY

YEAR

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