/
First Name:
Last Name:
Phone number:
Email Address:
Post Applied For:

VETTING INFORMATION

/ DETAILS OF CO-RESIDENTS
Please provide details of any co-residents currently residing at your address e.g. Lodger, family member (Do not include children under 16 years old)
Full name
Previous names/aliases
Date of birth
Association e.g. lodger
There are no co-residents at my address
PROOF OF IDENTITY
Please attach a copy of your full 10 year current British or EC passport (note if applicant is a British national & over 21 years old, a full passport which has elapsed within the last 5 years is acceptable.)
If you do not possess a passport, a copy of 2 other forms of identity from the following list must be attached:
A National Identity card
A British driving licence (if new style, please attach both sections showing photograph)
A full birth certificate (bearing an issue date within 6 weeks of birth)
A Chequebook & bankcard (accompanied by 3 separate statements & verification of signature)
A credit card (accompanied by 3 separate statements & verification of signature)
A photograph with a signed statement from a person of some standing in the community (e.g. Justice of Peace, Doctor), who has known the applicant for at least 3 years
IN ADDITION, PLEASE ATTACH PROOF OF RESIDENCY E.G. UTILITY BILL, BANK STATEMENT
AUTHENTICATION
Proof of identity: I enclose a copy of …………………………………….. as proof of identity
Proof of residency: I enclose a copy of …………………………..……… as proof of residency (current address)
VERIFICATION OF IDENTITY
I confirm that I have examined the original documents mentioned above and verify that they relate to the applicant. Relevant copies of the documents are attached.
Signature………………………………….. Name …………………………… Date……………
Department ………………………………………………..

For office use only: Vetting ref number …………………………….…

PLEASE ATTACH A RECENT PASSPORT SIZED PHOTOGRAPH TO THIS APPLICATION

Please read the following instructions carefully.

The information required in this questionnaire is to allow the Chief Constable to fulfil a statutory obligation to run an efficient and effective Force. To meet this obligation we must provide for the safety of our staff, and ensure that those with access to Force information are trustworthy and unlikely to breach confidences. Any infringement of an individual’s right to respect for family life European Convention on Human Rights ECHR - Article 8, and discrimination - ECHR Article 14 will only be that which is necessary and proportionate. The legitimate aims of such action will include the protection of the rights and freedoms of others, safeguarding public safety, the prevention of disorder and crime and in some cases national security.

The information will be treated in the strictest confidence. It is in your interest to make a full and frank disclosure, since withholding any relevant information may result in you being excluded from access to Force premises or computer applications. The data controller for the information collected by completion of this form is the above force. This information is to enable an assessment to be made as to the suitability of the applicant to gain access to police assets by way of undertaking appropriate checks of the data subject, relatives, guardians, and any individuals necessarily identified in the course of police enquiries. The checks will be undertaken by accessing national and local police systems and finance checks in order to establish any issues relating to past cautions, convictions, family, lifestyle, financial and social circumstances.

The personal data supplied will be managed confidentially, securely and in accordance with the Data Protection Act 1998. Personal data will be retained in accordance with retention periods established through the national guidance on Management of Police Information, where after it will be disposed of securely. Under the Data Protection Act, individuals have a general right of access to personal data held by forces.

Please complete the questionnaire in BLACK INK using BLOCK LETTERS. Check that you have completed ALL the questions by ticking responses as appropriate or by providing an answer in the spaces below. Where a question is not applicable or the answer is not known or not easily obtainable, enter N/A or N/K respectively. Please note that N/A or N/K responses may cause delay to your clearance. Should you require extra space to answer questions please insert a continuation page. Remember to complete the declaration on Page 8.


1
Financial position
This page is for Security vetting purposes and must be completed.
2
Previous addresses
This page is for Security vetting purposes and must be completed.
3
About your family
This page is for Security vetting purposes and must be completed.
4
About your family
(continued)
This page is for Security vetting purposes and must be completed.
5
Criminal histories
This page is for Security vetting purposes and must be completed
6
Declaration
This page is for Security vetting purposes and must be completed / Unless otherwise stated, complete these questions in respect of the last six years. If YES, you must provide full details (including dates). Failure to disclose accurate information may result in your application being terminated.
Yes NoDetails (including dates)
Have you had a loan arrangement
terminated by a bank/building society/
Finance house/other?
Have you had a credit/change/store or
cheque card withdrawn or notified that a
card or account had been defaulted?
Are you in arrears with any existing loan/
mortgage/hire purchase agreement?
Have you ever been registered as Bankrupt?
*If YES, have your bankruptcy debts been
discharged?
Have you had any court action taken against
You for any debt?
Have you been party to an Individual
Voluntary Agreement (IVA), Debt Referral
Order (DRO), Debt Management
Programme or a voluntary agreement
Registered with the County Court or a Sheriffs
Court or Court of Session Judgement in
Scotland?
Has a County Court judgement or Sheriffs
Court of Court of Session Judgement in
Scotland been made against you on financial
matters?
*If YES, has this been cleared?
Have you been the subject of an attachment of
earnings order?
Have you had repossesion proceedings
Commenced against you?
Have you consolidated all your debts with one
lender?
*If applicable, you will be required, at a later stage, to provide a Certificate of Satisfaction.
Please state below if there is any further information relating to your financial position that you should being to our attention.
APPLICANTS DETAILS
Surname: / Surname at birth (if different):
Any other previous surnames/aliases: / Reason for any change of name:
Forename(s): / Date of birth:
Town & country of birth:
Please give all addresses at which you have lived over the last five years. These must include details of home addresses, halls of residence or term-time addresses. Start with the most recent. Do not include your current address. Continue using the continuation sheets provided if necessary.
Full address / Postcode / Approximate dates from (month/year) to (month/year)
1.
2.
3.
4.
5.
6.
7.
8.
Please tell us about your family (wherever they live) and any other persons (aged 10+) living at your address. Provide full names including any middle names, previous family or surnames and maiden names. You should make it clear what their relationship to you is, i.e. if you are referring to your full sister you should delete brother, half and step. Continue using the continuation sheets provided if necessary. Please complete all sections or your application will be delayed.
Relationship to you
(delete as appropriate) / Full name (include previous surnames and name at birth, if different) / Full address (include postcode, and date moved to address, if known)
Yourself
Date and place of birth
Your spouse or partner
Date and place of birth
Your ex-spouse or ex-partner, if still in regular contact
Date and place of birth
Your father
Date and place of birth
Your stepfather or mother’s partner
Date and place of birth
Your mother
Date and place of birth
Your stepmother or father’s partner
Date and place of birth
Your brother or sister (full/half/step etc.,)
Date and place of birth
Your brother or sister (full/half/step etc.,)
Date and place of birth
Relationship to you
(delete as appropriate) / Full name (include previous surnames and name at birth, if different) / Full address (include postcode, and date moved to address, if known)
Your brother or sister (full/half/step etc.,)
Date and place of birth
Your brother or sister (full/half/step etc.,)
Date and place of birth
Your spouse’s or partner’s mother/ stepmother etc.,
Date and place of birth
Your spouse’s or partner’s father/
stepfather etc.,
Date and place of birth
Your spouse’s or partner’s mothers spouse or partner
Date and place of birth
Your spouse’s or partner’s father’s spouse or partner
Date and place of birth
Your child/child of partner (only state if aged 10+)
Date and place of birth
Other persons (aged 10+) living at your address (e.g. lodger)
Please state relationship to you
Date and place of birth
Convictions or cautions will not necessarily preclude you from appointment. It will depend on their nature and the circumstances of the offence. Failure to disclose convictions or cautions will, however, result in your application being refused.
You must declare all convictions for any past offences, formal cautions by the police (including cautions as a juvenile, i.e. under 18 years) and any bind-overs imposed by any court. You should include traffic convictions such as speeding, drink-drive offences, fixed penalties for motoring or disorder offences, anti-social behaviour and any appearances before a court martial.
You must also declare any charge or summons currently outstanding against you.
You must include spent convictions under the Rehabilitation of Offenders Act 1974 (by virtue of the provisions of the Rehabilitation of Offenders Act 1974 (Exemptions) Order 1975) or any involvement with civil, military or transport police.
You must also declare if you have ever been involved in any criminal investigation whether or not this led to prosecution (either of yourself or others).
Some applications do not declare information which they believe is no longer held on record. However, our enquiries will reveal incidents from long ago and failure to disclose these will lead to your application being rejected. If you have any doubts, include the details and let us decide if they are relevant.
We will also want to know whether any of your close family or associates are involved in criminal activity and we will therefore search for any criminal convictions or cautions recorded against them. You must advise them that these enquiries will be made. The Police Service cannot disclose the results of these enquiries to you.

Have you ever been convicted for any offence or had formal cautions
by police for any offence or any bind-overs imposed by any court?
(You must include traffic convictions, fixed penalties for motoring or disorder
Offences, anti-social behaviour orders and any appearances before a courtYES NO
Martial. Any cautions as a juvenile should also be included.) If you have
answered YES, please enter full details below.
Date (most recent first) / Offence/alleged offence / Result
(if known) / Court/police station involved
Criminal histories (continued)
Do you have any impending prosecutions?YESNO
If YES, provide full details.
Have you ever been involved in criminal investigation (whether or not this led
to any prosecutions)?YESNO
If YES, please give details below.
Have you ever been associated with criminals (including family member) YESNO
If YES, please give details below.
I declare that all the statements I have made in this application are true to the best of my knowledge and belief and that no relevant information has been withheld.
I understand that:-
  • Criminal conviction checks will be made against myself and my family members and 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.
  • Formal disclosure of my Service Character Assessment (Armed Forces) will be sought and I consent to this.
  • Any offer of appointment will be subject to satisfactory references and vetting, a medical examination, continued good conduct.
  • A member of a police force who has deliberately made any false statement or omitted information in connection with his or her appointment may subsequently be liable to misconduct proceedings.
  • Successful candidates must serve wherever required to do so within the force area.
  • The Chief Officer retains the right to reject any application without giving reasons.
  • The information I have provided may be held on manual filing and computer systems as part of the recruitment process. I understand this information may be shared by other police forces.
  • I am not and have never been a member of the BNP or similar organisation who aims, objectives or pronouncements may contradict the duty to promote race equality.

I agree with the above statement.
West Midlands Police is committed to providing equality of opportunity and in order to help us monitor the effectiveness of our vetting procedures, in relation to our Equal Opportunities Policy. Could you please complete the appropriate details below:
Please indicate the ethnic group to which you belong or from which you are descended:
British
Irish
Any other White background
White and Black Caribbean
White and Black African
White and Asian
Any other mixed background / Chinese
Any other ethnic group
Asian Indian
Asian Pakistani
Asian Bangladeshi
Any other Asian background / Black Caribbean
Black African
Any other Black background
Please tick box


West Midlands Police and Crime Commissioner
Lloyd House
Colmore Circus Queensway
Birmingham
B4 6NQ

0121 626 6060

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