Recruitment vetting form Stage 1 - Kent Police

RESTRICTED staff (when complete)Recruitment vetting form Stage 1This form can be completed electronically or by hand. You must provide all informationrequested, marking Not Applicable (N/A) in any fields that do not apply to yourcircumstances.To submit this form electronically, complete the form, save and attach to the email.Email it to: recruitment.businesscentre@kent.pnn.police.uk.To submit this form by post, address it to: Recruitment Team, Kent Police BusinessCentre, North Kent Police Station, Thames Way, Northfleet, Gravesend, Kent, DA11 8BD.For further information about our vetting process, readRecruitment/Security Vetting Guide – Your Questions answeredPlease click the link above to access the guide.Application detailsApplication No.:Candidate No.:Job Title and location:Applicant’s detailsTitle:Mr/Mrs/Ms/Dr/Other(please specify)*Last Name(s):First Name(s):Middle Name(s):Current address detailsAddress line 1:Address line 2:Address line 3:Address line 4:County:Postcode:Country:Kent Police eRecruitment vetting form Policy I11 * delete as applicableForm 2521c Stage 1 rev Feb 2010 v1.91 Page 1 of 5RESTRICTED staff (when complete)

RESTRICTED staff (when complete)Kent Police Recruitment vetting form – STAGE 1Section 1: Security questionsHave you ever been:Please SelectInvestigated by the Police Yes NoArrested by the Police Yes NoSummonsed for any offence by the Court/Police Yes NoCharged for any offence by the Police Yes NoIssued a fixed penalty notice Yes NoConvicted of any offence, including traffic offences (excluding parking) Yes NoCautioned / Reprimanded / Warned / Finally Warning for any offence, includingtraffic offencesYesNoIssued with an Anti-social behaviour order (ASBO), football spectator banningorder, risk of sexual harm order, or domestic violence or harassment orderHave you ever:YesNoPlease select(In Scotland) accepted a fiscal fine from the Procurators Fiscal Yes NoAppeared before a court martial Yes No(Note: You must include all matters referred to above, as the Rehabilitation of Offenders Act 1974does not apply to this declaration. ‘Spent’ convictions must therefore be declared).If you have answered Yes to any of the above questions please provide further information below(please use the free text section at the end of this form or a separate sheet if necessary):Date Offences / Incident Result, Court or Other Disposal(e.g. caution, bail, conviction etc)Are you currently the subject of any criminal investigation? Yes NoIf you answered Yes to the question above please give further details belowKent Police eRecruitment vetting form Policy I11 * delete as applicableForm 2521c Stage 1 rev May 2010 v2 Page 2 of 5RESTRICTED staff (when complete)

RESTRICTED staff (when complete)Kent Police Recruitment vetting form – STAGE 1Are you aware of any other circumstances or characteristics that mayaffect your suitability for appointment to the post applied for, (e ghabitual use of addictive substances (drugs or alcohol etc.) or any otherrelevant factors which could make you susceptible to pressure orimproper influences by any person)If Yes, please give details belowYesNoHave you previously been the subject of a vetting procedure? Yes NoIf Yes, please give details belowHave you ever had any vetting clearance refused or withdrawn? Yes NoIf Yes, please give details belowAre you, or have you ever been declared bankrupt? Yes NoIf Yes, please give details of date, court, amount involved and reason for debt belowDate Court Amount ReasonHave your bankruptcy debts been discharged? Yes NoIf you Yes, please enter month and year of dischargeAre you or have you ever been, a member of the BNP, National Front,Combat 18 or any similar organisations whose aims, objectives orpronouncements may contradict the duty to promote race equality? Yes NoIf Yes, please give details belowKent Police eRecruitment vetting form Policy I11 * delete as applicableForm 2521c Stage 1 rev May 2010 v2 Page 3 of 5RESTRICTED staff (when complete)

RESTRICTED staff (when complete)Kent Police Recruitment vetting form – STAGE 1Further informationKent Police eRecruitment vetting form Policy I11 * delete as applicableForm 2521c Stage 1 rev May 2010 v2 Page 4 of 5RESTRICTED staff (when complete)

RESTRICTED staff (when complete)Kent Police Recruitment vetting form – STAGE 1DeclarationI consent to the information contained in this questionnaire being submitted forchecking against the records of Police and Credit Reference Agencies.I declare that the information I have provided is true and complete to the best ofmy knowledge and belief.I confirm that any other persons listed have been notified that his/her detailshave been submitted as part of the vetting process.I undertake to immediately notify any material changes or additions in theinformation I have provided in this form, to the Kent Police Business Centre on01622 653653. I understand that failure to do so could disqualify me fromworking within the police service and could lead to prosecution.I understand that if I have knowingly made a false statement or deliberateomission in the information I have provided in this form to Kent Police I may bedisqualified.I also understand that information received during the vetting process is treatedin a confidential manner, although no immunity can be granted in respect of anycriminal matters revealed. In such cases, information contained within thisquestionnaire may be disclosed in any subsequent proceedings.Please mark the confirmation box to confirm you have read and understood thedeclaration above and provide your email address in the box providedI confirm that I have read and understood the above declaration:email address:Date:Kent Police eRecruitment vetting form Policy I11 * delete as applicableForm 2521c Stage 1 rev May 2010 v2 Page 5 of 5RESTRICTED staff (when complete)