Texas State Board of Pharmacy

This document is your FAST Fingerprint Pass for a state and national criminal history record check. Please schedule a fingerprint appointment by visiting or by calling 1-888-467-2080. When scheduling an appointment you will be prompted by L-1 Enrollment Services for the following additional personal data: Date of Birth, Sex, Race, Ethnicity, Skin Tone, Height, Weight, Eye Color, Hair Color, Place of Birth and Home Address. During your Fingerprint appointment you will also be prompted for Social Security Number and Driver License Number. Requested data is required by the Texas Department of Public Safety to process your background check. These data elements have been omitted from this document in order to better protect the security of your personal information. You may pay for FAST services online with a credit card or onsite with a check or money order only. Cash is not accepted! The fingerprinting fee will be provided during the appointment scheduling process. If you are submitting fingerprint cards as a non-resident, please contact us for fee information ( including information about which state you are being fingerprinted for and the reason you are being fingerprinted. 1. 2. 3. 4. 5. 6. Logon to Select: Texas Select: Online Scheduling Select: English or Espanol Enter: First and Last Name Select: All Others 7. 8. 9. 10. 11. 12. Select: Option A – Electronic Submission Select: Yes, I have a FAST Fingerprint Pass Enter: TX922090Z Enter: Designated Recipient’s Information Follow the prompts to enter requested information. Bring this completed form with you to your appointment.

Section One: Qualified Entity Information ORI#: TX922090Z Original Entity No: 0000691580
(If resubmission for rejected

Designated Recipient’s Name: Designated Recipient’s Address:

Marks, Lindsey




Section Two: Applicant Name (To be completed by Last (Please...

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