Merseyside Police Selection

Management Vetting 1 (MV 1)

Merseyside Police Selection

Integrity Check

This form must be completed and accompany applications for selection/appointment to designated posts outlined within the Force Vetting Policy.

Surname …………………………………………………………………………………………………

(All previous surnames if applicable)

………………………………………………………………………………………………………………

Forename (s) …………………………………………………………………………………………….

Forename (s) at birth (if different) ………………………………………………………………….

Date of Birth …………………………………………………………………………………………….

Place of birth / Nationality …………………………………………………………………………..

FIN/Employee number ……………………………………………………………………………….

(If existing police employee)

National Insurance number …………………………………………………………………………..

Full address ……………………………………………………………………………………..

……………………………………………………………………………………..

Full previous address if occupied less than 3 years

……………………………………………………………………………………..

Current posting/role ……………………………………………………………………..…………..

Telephone number (indicate daytime number)

Home …….……….…..…... Work ………………..….…. Mobile ………………………………..

Email ………………………………………………………………………………………………………

Post applied for ………………………………………………………………………………………….

Family Details

(To be completed in applications for designated posts only)

This is not required for promotion selection

Father Stepfather

Surname ……….………………………………….. Surname …….…………………………………………

(All previous surnames if applicable) (All previous surnames if applicable)

……………………………………………………… ……………………………………………………………

Forename (s)…..………………………………… Forename (s) …………………………………………..

Forename (s) at birth (if different) Forename (s) at birth (if different)

…………………………………………………….. …………………………………………………………..

Date of birth ……………………………………. Date of birth ………………………………………….

Place of birth …………………………..……….. Place of birth …………………………………………

Nationality ……………………………………….. Nationality …………………………………………….

At birth if different ……………………………. At birth if different ………………………………….

Full address …………………………………….. Full address …………………………………………..

…………………………………………………….. …………………………………………………………..

Occupation ……………………………………… Occupation ……………………………………….…..

Mother Stepmother

Surname ………………………………………….. Surname ……………………………………………….

(All previous surnames/maiden name if applicable)(All previous surnames/maiden name if applicable)

……………………………………………………… ……………………………………………………………

Forename (s) …..………………………………… Forename (s) …..………………………………………

Forename (s) at birth (if different) Forename (s) at birth (if different)

…………………………………………………….. …………………………………………………………..

Date of birth ……………………………………. Date of birth ………………………………………….

Place of birth …………………………………… Place of birth …………………………………………

Nationality ………………………………………. Nationality …………………………………………….

At birth if different ……………………………. At birth if different ………………………………….

Full address …………………………………….. Full address …………………………………………..

…………………………………………….……….. ……………………………………………………………

……………………………………………………… ……………………………………………………………

Occupation ………………………………………. Occupation …………………………………………….

Brothers/sisters - Stepbrothers/sisters (specify)

Surname …….…………………………………… Surname ……..………………………………………

(All previous surnames if applicable) (All previous surnames if applicable)

……………………………………………………… …………………………………………………………

Forename (s) …...………………………………. Forename (s) …..……………………………………

Forename (s) at birth (if different) Forename (s) at birth (if different)

…………………………………………………….. …………………………………………………………

Date of birth ……………………………………. Date of birth ………………………………………..

Place of birth …………………………………… Place of birth ……………………………………….

Nationality ……………………………………… Nationality …………………………………………..

At birth if different …………………………… At birth if different ………………………………..

Full address ……………………………………. Full address …………………………………………

…………………………………………………….. ………………………………………………………….

Occupation ……………………………………… Occupation …………………………………………..

Brothers/sisters - Stepbrothers/sisters (specify)

Surname ……..………………………………….. Surname ……..………………………………………

(All previous surnames if applicable) (All previous surnames if applicable)

……………………………………………………. …………………………………………………………

Forename (s) …………………………………… Forename (s) …..……………………………………

Forename (s) at birth (if different) Forename (s) at birth (if different)

……………………………………………………. …………………………………………………………

Date of birth ………………………….………. Date of birth ………………………………………..

Place of birth ………………………………….. Place of birth ……………………………………….

Nationality ……………………………………… Nationality …………………………………………..

At birth if different …………………………… At birth if different ………………………………..

Full address ………………………….………… Full address …………………………………………

…………………………………………………….. ………………………………………………………….

Occupation ……………………………. ……….Occupation …………………………………………..

IF ANY OTHER BROTHERS / SISTERS PLEASE PROVIDE DETAILS ON PAGE 11

Spouse/Partner – (a partner is classed as someone you have been in a relationship with for 6 months or more)

(Including details if divorced and previous partner within last three years)

Surname ……..…………………………………………………………………………………………………..

(All previous surnames if applicable)

………………………………………………………………………………………………………………………

Forename (s) …..………………………………………………………………………………………………..

Forename (s) at birth (if different)

………………………………………………………………………………………………………………………

Date of birth …………………………………………………………………………………………………….

Place of birth ……………………………………………………………………………………………………

Nationality ……………………………………………………………………………………………………….

At birth if different …………………………………………………………………………………………….

Date and place of marriage (if applicable) ……………………………………………………………….

Address if different from your home address

……………………………………………………………………………………………………………………..

Occupation ……………………………………………………………………………………………………..

Spouse/Partners parents

Father Mother

Surname …….………………………………… Surname …….…………………………………………

(All previous surnames if applicable) (All previous surnames if applicable)

…………………………………………………… ……………………………………………………………

Forename (s) …..……………………………… Forename (s) …..………………………………………

Forename (s) at birth (if different) Forename (s) at birth (if different)

……………………………………………………. …………………………………………………………..

Date of birth …………………………………… Date of birth ………………………………………….

Place of birth ………………………………….. Place of birth …………………………………………

Nationality ……………………………………... Nationality …………………………………………….

At birth if different ……………………………. At birth if different ………………………………….

Full address ………………………………….…. Full address …………………………………………..

…………………………………………….………. ……………………………………………………………

…………………………………………………….. ……………………………………………………………

Occupation ……………………………………… Occupation …………………………………………….

Residents of applicant’s home address (including children/dependants)

Surname ……..…………………………………. Surname …….………………………………………...

(All previous surnames if applicable) (All previous surnames if applicable)

…………………………………………………….. …………………………………………………………...

Forename (s) …………………………………… Forename (s) …..………………………………………

Forename (s) at birth (if different) Forename (s) at birth (if different)

…………………………………………… ………. ……………………………………………………………

Date of birth ……………………………………. Date of birth …………………………………………..

Place of birth …………………………………… Place of birth ………………………………………….

Nationality ………………………………………. Nationality ……………………………………………..

At birth if different ……………………………. At birth if different …………………………………..

Occupation ………………………………………. Occupation ……………………………………………..

Residents of applicant’s home address (including children/dependants)

Surname ……..…………………………………… Surname …….………………………………………...

(All previous surnames if applicable) (All previous surnames if applicable)

……………………………………………………… …………………………………………………………...

Forename (s) ……………………………………. Forename (s) …..………………………………………

Forename (s) at birth (if different) Forename (s) at birth (if different)

…………………………………………… ………..………………………………………………

Date of birth …………………………………….. Date of birth …………………………………………..

Place of birth ……………………………………. Place of birth ………………………………………….

Nationality ……………………………………….. Nationality ……………………………………………..

At birth if different …………………………….. At birth if different …………………………………..

Occupation ………………………………………. Occupation ……………………………………………..

Children no longer residing with applicant

Surname ………………………………………….. Surname ……………………………………….……….

(All previous surnames if applicable) (All previous surnames if applicable)

……………………………………………………… …………………………………………………………...

Forename (s) ……………………………………. Forename (s) …………………………………………..

Forename (s) at birth (if different) Forename (s) at birth (if different)

…………………………………………… ……………………………………………………………

Date of birth ……………………………………… Date of birth …………………………………………..

Place of birth ……………………………………. Place of birth ………………………………………….

Nationality ……………………………………….. Nationality ……………………………………………..

At birth if different ……………………….…….. At birth if different …………………………………..

Full address ………………………………………. Full address …………………………………………….

…………………………………………………….… …………………………………………………………….

Occupation ………………………………………. Occupation ……………………………………………..

IF ANY OTHER CHILDREN PLEASE PROVIDE DETAILS ON PAGE 11

Continuation sheet

(Please include any other information that may be relevant to this application)

(Example : children’s father/mother, brothers, sisters, children if not named on this form in previous section)

………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………..….

………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………...

………………………………………………………………………………………………………………………………

Financial Information

All questions relate to applicant only.

Unless otherwise stated, please complete these questions in respect of the last six years.

A check will also be conducted with an external credit-scoring agency.

Yes / No

Have you had a loan arrangement terminated by a bank/building society/finance house/other financial institution?
Have you had a credit/charge/store or cheque/debit card withdrawn?
Have you been served with a default notice on any credit agreement?
Are you currently in arrears with any existing loan/mortgage/credit card/hire purchase agreement?
Have you ever been registered bankrupt?
If yes, have your bankruptcy debts been discharged?
If yes, when?
Have you ever been the subject of a County Court Judgement on a financial matter?
If yes, has the CCJ been cleared?
If yes, when?
If applicable, please provide a copy of the Certificate of Satisfaction
PLEASE NOTE APPLICATIONS WILL NOT BE ACCEPTED WHERE THERE ARE OUTSTANDING CCJs
Have you been party to a voluntary agreement registered with the County Court?
Have you had repossession proceedings commenced against you?

Police Officers Only

I do / do not currently have authorisation for a business interest in accordance with Police Regulations.

The approved interest relates to :

……………………………………………………………………………………………………………………

The information contained within this form will be forwarded to the Force Vetting Unit (Professional Standards Unit) to enable an integrity check to be completed. With regards to internal applicants the purpose of the check is to ensure that candidates who are applying for designated posts do not have any disciplinary matters or other issues either pending or dealt with which would bring in to question their suitability at this time.

The check in respect of external applicants is made to ensure that there are no issues, which would compromise their employment with Merseyside Police.

The Integrity Check will involve as appropriate the interrogation of all information systems used by Merseyside Police both locally and nationally.

In the event that any relevant information is divulged which requires confirmation or clarification it may be necessary to disclose information contained within this form to other organisations or agencies not part of Merseyside Police.

As part of the aforementioned confirmation or clarification the organisation or agency concerned may be requested to disclose personal information.

DECLARATION

I understand that:

· I must inform the Force Vetting Manager (PSU) without delay of any change in my circumstances.

· Criminal conviction checks will be made against my family members and myself, I have informed them of this.

· Financial checks will be undertaken to verify my financial status and that all such information will be treated in confidence. I consent to these checks being made.

· A member of a police force who has deliberately made any false statement or omitted information in connection with his or her application or appointment may be liable to discharge or misconduct proceedings.

· The information I have provided may be held on manual filing and computer systems as part of the integrity process. I understand this information may be shared by other police forces.

Signature …………………………………………………… Date ……………………………………

Part 1a (For completion by applicant/candidate)

Internal applicants

I am aware of the Force Vetting Policy as published on the Force Intranet system and give my

consent for the check to be completed in the terms outlined.

Signature ……………………………………………………………………………….

Rank and FIN/Employee Number ………………………………………………..

(Existing police employee)

Date / /

External applicants

I give my consent for the checks to be completed in the terms outlined.

Signature ………………………………………………………………………………

Date / /

Part 1b (For completion by applicant/candidate : Internal/External)

Are you or have you ever been a member of the BNP or similar organisation whose constitution, aims, objectives or pronouncements may contradict the duty to promote race equality?

Yes / No

Part 2 (To be completed by Line Manager in respect of all police staff applications (internal applications)

The personal file of the applicant has been checked: (Delete as appropriate)

a) There are no disciplinary findings recorded.

b) Disciplinary findings as below are recorded.

Date / /

Signed …………………………………………………………………………………..

Line Manager

Date / /

For use by Force Vetting Unit (PSU)

Integrity Check completed Yes / No Date / /

Issues revealed Yes / No Date / /

Referral to Chief Superintendent - Professional Standards Department

Yes / No Date / /

Line Manager informed Yes / No Date / /

Decision of Chief Superintendent – Professional Standards Department

Application allowed

Yes / No

Date / /

Diversity Monitoring Form

Merseyside Police is an equal opportunities employer and is determined to ensure that no job candidate or member of staff: -

§ is treated less favourably on the grounds of sex or marital status; colour, race, sexual orientation/sexuality; religion; age; or disability.

§ is disadvantaged by a provision, criterion or practice that cannot be objectively justified by the requirements of the job.

The information on this form is for monitoring purposes only; it will not affect your application in any way and will not be made available to those assessing your application. It is important that all sections of this form are completed as it is an essential part of our monitoring process.

Please place only one cross in the appropriate box for each section.

Ethnic/Racial Groups Gender

White Male

British Female

Irish

Other White background

Mixed or Mixed British Marital Status

White & Black Caribbean Not married

White & Black African Married

White & Asian Civil Partnership

Other mixed background

Asian or Asian British

Pakistani Are you disabled?

Bangladeshi Yes

Indian No

Other Asian background

Black or Black British

African

Caribbean Current Employment Status

Other Black background Full Time

Chinese/Other Ethnic group Part Time / Job Share

Chinese

Any other

Religion or belief Age Band

Christian Under 25 25 – 40 41 – 55

Buddhist Above 55

Hindu

Muslim

Jewish Sexual Orientation

Sikh Gay/Lesbian

Any other Bisexual

None Heterosexual

Prefer not to say

I give consent for all or part of the information provided on this form to be processed on the Merseyside Police computerised recruitment system.

Candidate’s Signature : Date :