Medicaid Fraud Patient Abuse
Tobacco Litigation & Enforcement
Each officer of the applicant and every employee or agent of the applicant with access to the trust account must return a completed card to:
Director of Consumer Protection Office of the Attorney General 820 N. French St. 5th Floor Wilmington, DE 19801
The fingerprint cards must be taken to a local law enforcement agency for applying prints and the agency may charge a fee. You will receive additional instructions when you receive the cards.
Number of Fingerprint Cards & Authorization Forms you need:
Full Name:
Address:
Business Name:
Business Address:
Phone Number:
Email Address: