Criminal Background Clearance Transfer Request Form
This form is necessary for transferring active criminal record clearances between state licensed facilities or organizations in California. It must be submitted before client contact occurs to avoid legal penalties. Ensure all required documents and identifications are included to avoid delays.
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How do I fill this out?
To fill out this form, start by providing the personal details of the individual whose clearance is being transferred. Then, accurately fill in the information of both the current and new facilities involved in the transfer. Finally, ensure you attach all required identification documents and the LIC 508.

How to fill out the Criminal Background Clearance Transfer Request Form?
1
Obtain the individual's personal identification details.
2
Complete the information of both facilities involved.
3
Attach required identification documents.
4
Submit the form to the appropriate licensing body.
5
Ensure submission is done before client contact occurs.
Who needs the Criminal Background Clearance Transfer Request Form?
1
License applicants needing to transfer a criminal record clearance.
2
Facility administrators ensuring compliance with regulations.
3
Child care facility staff managing background checks.
4
Employees relocating to new licensed organizations.
5
Non-client adult residents wishing to maintain facility association.
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What are the instructions for submitting this form?
To submit this form, complete all necessary fields and include required identification documents. You can send the form via mail or fax to the local licensing office. For physical submissions, ensure to visit during office hours and retain a copy for your records.
What are the important dates for this form in 2024 and 2025?
Important dates for submitting this form include submission deadlines for 2024 and 2025, which may vary based on facility operational schedules. It's essential to check for any updates provided by the California Department of Social Services during those years. Stay informed about any legal changes affecting submission timelines.

What is the purpose of this form?
The purpose of the Criminal Background Clearance Transfer Request Form is to streamline the process of transferring active criminal record clearances between licensed facilities in California. This ensures that individuals maintain compliance with state laws governing client contact and background checks. It is vital for safeguarding both individuals and the facilities they serve.

Tell me about this form and its components and fields line-by-line.

- 1. Last Name: The surname of the individual.
- 2. First Name: The first name of the individual.
- 3. Middle Initial: The middle initial of the individual.
- 4. CA Driver's License or ID: The California driver's license number or state ID.
- 5. DOB: Date of birth for identity verification.
- 6. Facility/Organization Name: Current facility from which clearance is being transferred.
- 7. Transferee Facility Name: New facility to which the clearance is being transferred.
- 8. Signature: Signature of the individual verifying the form.
What happens if I fail to submit this form?
Failure to submit this form may result in violations of state regulations, leading to penalties or fines. It's crucial to avoid client contact until the transfer is properly processed to ensure compliance. Delays can hinder employment opportunities or facility operations.
- Legal Penalties: Not submitting the form leads to potential fines.
- Operational Delays: Facilities may face operational issues without clearances.
- Employment Consequences: Individuals may lose job opportunities if not compliant.
How do I know when to use this form?

- 1. Employment Change: When starting a new job at a different facility.
- 2. Facility Transfer: Transferring clearances due to moving to a new licensed location.
- 3. New Facility Requirements: Connecting with a new facility that demands clearances.
Frequently Asked Questions
How do I fill out this form?
Simply input the required information in the designated fields and ensure all attachments are included.
Can I edit this PDF online?
Yes, our platform allows easy editing of the PDF before submission.
How do I submit the form?
You can submit the form via mail, fax, or in person at the licensing office.
What if I make a mistake?
You can easily go back and edit any part of the PDF before downloading it.
Is there a fee for processing this form?
No specific fees are mentioned for the transfer request, but check with your licensing office.
Do I need to provide my Social Security Number?
Providing your SSN is voluntary, but it may expedite processing.
Can I share the PDF with others?
Yes, you can use our sharing features to distribute the document easily.
What happens after submission?
Once submitted, the licensing body will review and process your transfer request.
Is my information secure?
While we focus on easy access and sharing, we do not store personal information.
How can I download the edited PDF?
After editing, simply select the download option to save it to your device.
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