Dallas Police Department Applicant Personal …

1 Dallas Police Department Applicant Personal History Statement TEXAS COMMISSION ON LAW enforcement . OFFICER Applicant Personal HISTORY FORM. Effective F e b r u a r y 1 6 , 2 0 1 6. NAME. DATE ISSUED. COMPLETE AND RETURN BY. I am applying for: [ ] Peace Officer PID# [ ] Civilian Em ployment Dallas Police Department Personal HISTORY STATEMENT FEBRUARY 16, 2016 . Personal History Statement Instructions E mp loy ee s ar e e xp o s ed to con fid en t ia l an d l a w en for c e me n t s en si ti v e i n fo rm ati on . A th orou gh b ac kg rou n d in ve s ti gat ion i s r eq u i r e d to p rop e rly e val u at e t h e s u ita b i lity o f ap p l ic a n ts for e mp loy m en t w it h th e ag en cy . Alth ou gh it i s a n ach i e v em en t to r ea ch th e b ack grou n d p h a s e o f th e h i rin g p r oc e s s, t h i s i s sti ll a co mp eti ti v e p roc e s s an d d oe s n ot, in a n y way , g u aran t e e s el e cti on.

2 Th e s e in st ru cti on s ar e p ro vid ed a s a gu id e t o as s i st y ou in p rop er ly co mp l et in g y ou r P er s on al H i sto ry Stat e m en t . I T I S ES S EN TI A L TH A T T H E IN F OR M AT I ON I S AC CU RA T E IN AL L R ES P EC T S S O PL E A S E R EA D AL L. IN STR U CT IO NS C AR E F UL LY B EF OR E PR OC E E D IN G . Th e Pe r son a l H i sto ry Stat e m en t w il l b e u s ed as a b a s i s fo r a b ac kg rou n d in v e sti gat ion th at wi ll d e t er min e y ou r el ig ib i li ty for b e co min g a n em p loy e e. 1. You r ap p li cat ion mu s t b e ty p ed or p ri n t ed l e g ib ly in B LA C K IN K. An s w er all q u e sti on s tr u th fu l ly an d acc u rat e ly . 2. If a q u e sti on i s n ot ap p l icab l e to y ou , en t e r N O or N ON E in th e sp ac e p r ov id ed.

3 3. A void er ror s b y r e ad in g th e d i re ct ion s c ar e fu l l y b e for e mak in g an y en tri e s on th e for m. Be s u re y o u r in f or mat ion i s a cc u rat e an d in p rop e r se q u e n c e b e for e y ou b eg in . 4. You ar e r e sp on si b l e fo r ob t ain in g c orr e ct a n d fu ll ad d r e s s e s. I f y ou ar e n ot su r e o f an ad d r e s s, p er s on al ly v er i fy b e fo r e ma kin g t h at en try o n th e h i sto ry st at em e n t. A L L A D DR E SS E S M U ST B E. COM P L ET E W IT H Z I P C O D E S. 5. If y o u n e ed ad d i tion al s p ac e for y ou r an s w er s, mak e a n ad d i tio n al cop y of th e ex ac t p ag e to co mp l et e th e r eq u e st ed in fo r mat i on , an d f il l in on ly th e n ec e s sa ry in f or mat ion.

4 6. An a ccu rat e an d co mp l et e for m w il l h e lp exp e d it e you r in v e sti ga tion . Om is s io n s o r f al s i fi c a tio n s wi ll re su lt in d isq u a l if ic at io n . 7. You a re r e sp o n s ib l e for fu rn i sh in g an y ch an g e s an d / or u p d a tin g y ou r ap p li cati on a s n e ed ed , su ch a s ad d r e s s ch an g e s or t e le p h on e ch an g e s in wr itin g. 8. An y c an d i d at e su b m itt in g an in c o mp l et e ap p l ic a tion W IL L N O T B E C ON S I D ER E D FO R EM PL O YM E N T . You r ap p li cat ion w i ll b e e v al u ated o n c o m p let en e ss an d n e atn e ss . 9. Be lo w i s th e li st o f th e r eq u ir ed d o cu m en t s n e e d ed fo r t e st in g.

5 Dal la s Pol ic e Pe r son n el wil l ma ke cop i e s of th e d o cu m en t s : Printed & completed copy of City of Dallas application Val id d ri v er' s li c en s e Soc ia l S e cu r ity ca rd ( n o p h oto cop y ). Ori gi n al b ir th c e rti f ica t e Of f ic ial U . S . h igh s ch o o l tr an sc rip t or GE D ( se al ed o ri gin a l s in en v elo p e ). On e co ll e g e tr an sc rip t f ro m e ve ry u n i ve r sit y att en d ed ( se al ed ori gi n al s in en ve lop e ). Ori gi n al m il ita ry D D For m 21 4, m e mb er - 4 (i f a p p li cab le ). Ori gi n al m il ita ry N G B- 2 2 (i f a p p l ica b l e). (I f th e a p p l ica n t i s st ill in th e mi lita ry , a sta te m en t o f s er v ic e l ett er f ro m t h e ap p li c an t' s Co m man d in g O f fi ce r st atin g th e ap p li can t i s i n good s tan d in g, d at e of en l i st m en t, d at e o f en d o f act i ve s e r vi ce , an d p roj ec te d h on orab l e d i s ch a r ge.)

6 Ori gi n al m arr ia ge l ic en s e Cop y of d i vo rc e d e cr e e Ori gi n al n atu ral izat ion d ocu m en t, i f ap p li cab l e (N o p h oto cop y ). Fin a l d i sp o si tio n s on arr e st s, i f ap p li cab le (o b ta in e d b y cal lin g th e c ou r t o f ru lin g t o ob tain c er tif i e d cop y ). Fin a l d i sp o s iti on s o f ci t ation s r ec e i ve d wi th in t h e p r e viou s 1 y e ar (o b t ain ed b y ca ll in g c ou rt wh er e cit ati on w a s i s su ed . W ill sh ow h o w th e ci tat io n wa s c l ear ed p a id , d is m i s se d , co m mu n ity s e rv ic e et c. ). 10 . If y ou h a v e a n y q u e st io n s, p l ea s e c on ta ct Po li c e P e rs on n el D iv i si on (2 1 4) 6 71 -4 4 09.

7 2. Dallas Police Department Personal HISTORY STATEMENT FEBRUARY 16, 2016 . Applicant Qualification Section Be f or e y o u b eg in to fi l l ou t th i s p er s on al h i st ory st at em en t, p l ea s e en su r e th at y ou me et t h e fo ll ow in g req u ir e m en t s. You m u s t m e et al l fi v e o f th e se re q u i re m en t s to q u al i f y fo r l ic en su r e a s a p ea ce o ff ic e r o r jail e r in Te xa s. INITIAL REQUIREMENTS. 1. I a m a ci tiz en of th e Un i ted Sta t es o f A m e ri ca. 2. I h a v e earn ed a h i gh s ch ool d ip l o ma o r a GE D. 3. I h av e n e ve r b e en c on vi ct ed , p le ad gu i lty ( n olo c on t en d er e ), n or h av e I. b e en on c ou rt -o rd er ed c om mu n ity s er v i ce /p r ob at ion o r d e f er red ad ju d i cat ion f or a C la s s A mi sd e m ean o r o r a f el on y.

8 4. Du r in g th e la s t ten (1 0) y ear s, I h a v e n ot b e en con vi ct ed , p l e ad gu i lty (n ol o con t en d er e ), b e en on co m mu n ity se r vi ce /p r ob at ion or d e f er red ad ju d i cat ion f or a C la s s B mi sd e m ean or in th i s st at e, o th e r st at e, o r wh i l e s er v in g in t h e m il ita ry . 5. I h a v e n e v er h ad a m il it ary cou r t ma rti al th at r e su l ted in a d i sh o n or ab le or b ad c on d u c t d i s ch a rg e. Disqualification Th er e ar e v ery f e w au to mat ic b a s e s fo r r ej e cti o n . E v en i s su e s o f p rio r mi s con d u ct, em p loy e e t er m in at ion s, an d ar r e st s a r e u su a ll y n ot, in an d o f th e m s el v e s, a u to ma ti cal ly d i sq u a li fy in g.

9 Ho w e v e r, d el ib erat e mi s st at e me n t s or o mi s s ion s can an d o ft en wi ll re su lt in y ou r ap p l ica ti on b ei n g r ej e ct ed , r ega rd l e s s of th e n atu r e o r r ea so n f or t h e mi s st at e me n t s/ om i s si on s. In fac t, th e n u mb er on e r ea son in d i v id u al s f ai l . b ack gro u n d in v e st ig ati o n s is b e cau s e th ey d e lib era te ly wi th h o ld or m i sr ep r e s en t re l e van t in for mat ion fr o m th e ir p ro sp ec ti v e e mp l o y er . Th is p e r son a l h i st ory sta te m en t i s a go v ern m en ta l d o cu m en t. B e tr u th fu l, as th er e are cr i min al con s eq u en c e s fo r ly in g on a go v ern m en ta l d ocu m en t. 3. DALLA S P O LI CE Department PERSONA L HI STORY STATEMENT FE BRUA RY 1 6 , 201 6.

10 Applicant Identification INFORMATION PROVIDED IN THIS SECTION IS USED FOR IDENTIFICATION PURPOSES ONLY. Last Name First Middle Maiden Street Address Apt. No. City State & Zip Code Mailing Address (if different from residence) State & Zip Code Home Telephone No. Work Telephone No. Cellular No. Pager No. Date of Birth Social Security No. Drivers License No. & State H av e y ou e v er b e en k n o wn o r gon e b y an y ot h e r n am e ( ex c lu d in g n i ck -n am e s) ? I f y e s, gi v e d et a il s. Pla ce o f Bir th (C ity , Co u n ty , S tat e, Cou n try ). Ar e y ou a U. S. C iti zen b y Bi rth ? Ar e y ou a N atu r al iz ed Cit iz en ? He igh t We igh t E y e Co lor Hair C olo r Sca r s, Ta ttoo s (d e sc rip ti on an d lo cat ion ) or oth e r d i st in g u i sh in g m ark s Do y o u h a v e a s oc ial n et wo rkin g, in stan t m es s ag in g, or oth er in t ern et -b as ed p ro fi l e( s ) ?