Applying for a position within child and youth services demands thorough vetting and specific documentation, and the DA Form 3433-2 plays a critical role in this process. Designed to assess eligibility for such sensitive roles, this supplemental employment application form is a gateway for candidates aiming to work within this sector. Governed by the regulations set out in AR 215-3 and mandated by the Department of Defense, School Support Services, G1, the form gathers essential personal data under the guidance of the Privacy Act of 1974. By requesting detailed information including social security numbers, employment history, and any criminal records related to sex crimes or offenses involving children, the form ensures that only those suitable are considered for positions impacting the welfare of minors. Moreover, it underscores the importance of truthfulness by highlighting the repercussions of perjury under federal law. This diligent approach not only aids in maintaining the integrity of child and youth services but also safeguards the interest of the applicants, ensuring their qualifications and background align perfectly with the demands of the job. Through the DA Form 3433-2, the intricate balance between the necessity for thorough vetting and the privacy rights of the applicants is navigated with precision, reflecting the seriousness with which child and youth service positions are regarded.
| Question | Answer |
|---|---|
| Form Name | Da 2 3433 Fillable Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | da 3433, da 2 3433, 3433 2, supplemental proponent dcs blank |
For use of this form, see AR
|
DATA REQUIRED BY THE PRIVACY ACT OF 1974 |
AUTHORITY: |
Public Law |
PRINCIPAL PURPOSE: |
To determine your eligibility for service in a child care services position. |
ROUTINE USES: |
We must have your social security number (SSN) to keep your records straight because other people may have the |
|
same name and birth date. The SSN has been used to keep records since 1943, when Executive Order 9397 asked |
|
agencies to do so. We may also use your SSN to make requests for information about you from employers, |
|
schools, banks, and other who know you, but only where allowed by law. The information we collect by using your |
|
SSN will be used for employment purposes, and also for studies and statistics that will not identify you. We may |
|
give information from your records to appropriated federal agencies such as the Department of Labor and the Equal |
|
Employment Opportunity Commission, to resolve and/or adjudicate matters falling within their jurisdiction. Records |
|
may also be disclosed to labor organizations in response to requests for names of employees and identifying |
|
information. Information we have about you may also be given to federal, state, and local agencies for checking on |
|
law violations or other lawful purposes. |
DISCLOSURE: |
Your responses to the collection of this information are voluntary, but we cannot determine your eligibility, which is |
|
the first step toward getting the job, if you do not answer these questions. |
1. NAME
2a. SSN
3. JOB ANNOUNCEMENT/TITLE
4. ADDRESS
2b. DOB (YYYYMMDD)
5. WORK PHONE
6. HOME PHONE
7. FAX TELEPHONE NUMBER
8.
9.HAVE YOU EVER BEEN ARRESTED FOR OR CHARGED WITH A SEX CRIME, A CRIME INVOLVING A CHILD, A SUBSTANCE ABUSE FELONY OR A VIOLENT CRIME? HAVE YOU EVER BEEN ASKED TO RESIGN BECAUSE OF OR BEEN DECERTIFIED FOR A SEXUAL OFFENSE? If so, provide an description of the case disposition.
YES
NO
Note: A false statement rendered by an employee may result in adverse action up to and including removal. Under 18 U.S. Code 1001, the federal punishment for perjury is fine or imprisonment for up to 5 years, or both.
I declare under penalty of perjury that the information contained in this application form and any attachments or
documents submitted in connection with my application for this position are true and correct to the best of my
knowledge, information, and belief.
10. SIGNATURE
11.DATE (YYYYMMDD)
DA FORM |
DA FORM |
USAPA V2.00ES |