BUSINESS, CONSUMER SERVICES AND HOUSING AGENCY • GAVIN NEWSOM, GOVERNOR
DEPARTMENT OF CONSUMER AFFAIRS
BUREAU OF SECURITY AND INVESTIGATIVE SERVICES
P.O. Box 989002, West Sacramento, CA 95798-9002
P (916) 322-4000 | P (800) 952-5210 | F (916) 575-7290 | www.bsis.ca.gov
SECURITY GUARD REGISTRATION RENEWAL APPLICATION
NOTE: Read Fee Amount Due under Instructions carefully to help ensure payment of correct fee amount.
An application received without full payment will not be processed and will be returned to the applicant.
(COMPLETE ELECTRONICALLY ON COMPUTER OR PRINT CLEARLY IF HANDWRITTEN)
Last Name First Name Middle Name
Fee Amount (SEE INSTRUCTIONS)
$
Guard Registration Number
Registration Expiration Date
Date of Birth (MM/DD/YYYY)
Address of Record (Address, City, State & Zip Code) (SEE INSTRUCTIONS)
Residence Address (Address, City, State & Zip Code) (SEE INSTRUCTIONS)
Check box if requesting to update your address(es) with the Bureau (SEE INSTRUCTIONS)
Telephone (Optional) (SEE INSTRUCTIONS)
Email Address (Optional) (SEE INSTRUCTIONS)
Pursuant to BPC section 7583.20, you MUST HAVE COMPLETED, and you must certify that you have completed, all
training required by section 7583.6, subdivision (b) as set out below as a condition for renewal.
Within 6 months of Initial Registration: 32 hours of security guard skills training must have been completed
within six months of registration as detailed below:
1. At least 16 hours within 30 days of registration
2. Additional 16 hours (for a total of 32 hours) within 6 months of registration
Pursuant to BPC Section 7583.6, subdivision (f), you must complete the following training.
Annual Training: 8 hours of security guard skills training must be completed annually.
Mandatory Disclosure Language
Submission of the requested information is required unless otherwise noted as optional. The Bureau of Security and
Investigative Services (BSIS) of the Department of Consumer Affairs (Department) cannot process your Security Guard
Registration Renewal Application unless all requested information is provided.
Pursuant to the Information Practices Act, the BSIS is responsible for maintaining the information in this application. You have
the right to review the records maintained on you by the BSIS or Department unless the records are exempt from disclosure by
section 1798.40 of the Civil Code. Your completed application becomes the property of the BSIS and will be used by authorized
personnel to determine your eligibility for a license, registration or permit. Information on your application may be transferred
to other governmental or law enforcement agencies, as permitted by law.
Pursuant to the California Public Records Act (Gov. Code § 6250 et seq.) and the Information Practices Act (Civ. Code §
1798.61), information about persons possessing a license, certificate, permit or registration may be disclosed by the BSIS
unless otherwise specifically exempt from disclosure under the law. The Address of Record of each licensee is not exempt
from disclosure and will be released upon request by a member of the public. The BSIS makes every effort to protect the
exempt personal information you provide us. Exempt information provided by you, however, may be disclosed in response to
a court or administrative order, a subpoena, or a search warrant.
For questions about this notice or access to your record, you may contact the BSIS by mail at Bureau of Security and
Investigative Services, Attn: Custodian of Record, P.O. Box 980550, Sacramento, CA 95798-0550; by phone at
(800) 952-5210; or by e-mail at bsis.prarequests@dca.ca.gov. For questions about the Department’s Privacy Policy, you may
contact the Department of Consumer Affairs at 1625 North Market Boulevard, Sacramento, CA 95834, by phone at
(800) 952-5210 or by e-mail at dca@dca.ca.gov.
U.S. ARMED FORCES PRIORITY REQUESTS
Check box if you have served, or are currently serving, in the U.S. Armed Forces.
Disclosure is voluntary. If you check the box, submit proof of your military service (e.g. DD-214, DD-256, V-MET record,
military orders, military I.D., etc.) with your application.