| Transaction Information | |
| Fingerprint Card User |
|
| Payment Type |
|
*
|
 |
No unemployment cards, child support cards or gift cards are accepted. |
|
| ABID |
|
| ABID Password |
(case sensitive) |
| Reason Fingerprinted |
* |
| Employer Name |
*
|
| Personal Information |
| Last Name |
* |
| First Name |
* |
| Middle Name |
|
| Date of Birth |
(MMDDYYYY)* |
| Place of Birth |
* |
| SSN(no dashes) |
* |
| Reenter SSN |
* |
| Sex |
* |
| Race |
* |
| Eye Color |
* |
| Hair Color |
* |
| Height |
* |
| Weight |
*
|
| Country of Citizenship |
* |
| Driver's License No. |
|
| Address |
* |
| City |
* |
| State |
* |
| Zip |
* |
| Phone # |
* |
| E-Mail Address |
|