Fingerprint Referral Form PDF Details

The Fingerprint Referral Form, utilized by the New York City Department of Education Division of Human Resources & Talent, represents a crucial step in the hiring and vetting process for potential employees. With a structure aimed at collating comprehensive personal information, the form is meticulously divided into sections, overseen by various offices within the department. The first section requires completion by an authorizing official and collects certification details about the referring individual. The subsequent part, filled out by the applicant, features probing questions that delve into the applicant's background, probing for any legal infractions or situations that might affect their eligibility for employment. The final segment shores up the process by ensuring employment eligibility, tying in with the broader due diligence efforts of the Office of Personnel Investigation. This intricate setup underscores the department's commitment to safeguarding its educational environment, ensuring only qualified and vetted individuals make their way through. Central to this initiative is the transparency and truthfulness expected from applicants, especially in disclosing criminal records, which, if not accurately reported, could result in application denial, underscoring the critical balance between privacy rights and the need for security within educational institutions.

QuestionAnswer
Form NameFingerprint Referral Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other names65 court street fingerprinting, doe fingerprinting, doe fingerprint referral form, nycdoe applicant gateway

Form Preview Example

The New York City Department of Education

Division of Human Resources & Talent

65 Court Street, Brooklyn, New York 11201

FINGERPRINT REFERRAL FORM

GENERAL INSTRUCTIONS: Please print all information clearly on the form. Section I (Certification Referring Official) must be completed by the appropriate office. Section II (Background Questions) must be completed by the applicant. Section III (Employment Eligibility Verification) will be completed by the Office of Personnel Investigation.

 

 

 

OFFICE USE ONLY

 

 

 

 

 

I-9 CODE

 

 

 

 

ORG.

 

 

 

 

 

 

CODE

 

 

 

 

 

 

Y

REXP. DATE _______/_______/_______

A EXP. DATE _______/_______/_______

PLACE OF BIRTH

HEIGHT/

FEET INCHES

WEIGHT

HAIR COLOR

EYE COLOR

SECTION I: BACKGROUND INVESTIGATION IN THE TITLE OF

Signature of Referring OfficialOffice/DistrictTelephone Number

SECTION II: BACKGROUND QUESTIONS

TODAY’S DATE

SOCIAL SECURITY NUMBER

Month Day Year

LAST NAME

-

FIRST NAME

Month Day Year

-

M.I.

Male Female

OTHER OR MAIDEN NAME

DATE OF BIRTH

CHECK THE BOX BELOW WHICH BEST DESCRIBES YOU:

PLEASE (√) ONE

1.

2.

AMERICAN INDIAN/ALASKAN NATIVES

3.

ASIAN: INCLUDES ASIAN INDIANS, CHINESE,

4.

JAPANESE, KOREANS, FILIPINOS, INDONESIANS,

 

AND POLYNESIANS

5.

BLACK (Not of Hispanic Origin)

HISPANIC

WHITE (Not of Hispanic Origin)

STREET ADDRESS

 

 

 

 

APT. NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

STATE

 

ZIP CODE

-

-

(AREA)

TELEPHONE NUMBER

FILE NUMBER (IF ANY)

E-MAIL ADDRESS

 

FORM 551 (1096)

Answer “YES” or “NO” to the following questions. If your answer to any of these questions is “YES”, explain, giving details, in the space provided below. You must answer these questions truthfully even though you may have disclosed the same information to the Department of Education or another agency on a previous occasion. Please be advised that if you answer “NO” to question #1 and your fingerprint results disclose a conviction record, your application will be denied. Please sign your name at the end of this section.

YES NO

Have you ever been convicted of or pled "GUILTY" or pled "NO CONTEST" to any offense in this state or

1.elsewhere? [This includes Felonies, Misdemeanors and Violations. For Felonies or Misdemeanors, you must answer "Yes" if you were convicted or pled guilty or no contest even if your records have been sealed.]

2.Are any criminal charges currently pending against you anywhere?

3.Have you ever been placed on a state registry as a sex offender in New York State or elsewhere?

4.Have you ever forfeited bail or bond following your appearance as a defendant in a criminal court action?

5.Has a warrant been issued by a court requiring that you appear in court?

6a.

Has a Family Court ever found that you abused or neglected a child? If so, explain below which court issued

the finding, the nature of the finding, and when it happened.

 

 

6b.

Are you currently in arrears [4 months or more] for child support payments?

 

 

7.

Have you ever been discharged [fired] or required to resign from any position for reasons other than a layoff

due to reduction in the work force?

 

 

8.

Have you ever been denied employment as a result of information obtained following a background check or

 

investigation? If so, explain the reasons for denial of employment below.

9.

Have you ever resigned or left a job rather than face charges or dismissal?

 

 

10a.

Has an employer ever brought or filed charges against you?

 

 

10b.

If yes, were you found guilty of the charges?

11.Have you ever had any professional certificate or license denied, revoked or suspended?

Have you ever applied for a civil service position, such as police officer or worker for a federal, state, city or

12.local agency, and been notified you do not qualify?

Have you ever had a teaching license or certificate denied, revoked or suspended by any Education

13.Department: New York City, New York State or elsewhere?

14.Have you ever received an unsatisfactory rating or unsatisfactory evaluation for your work in a school?

15.Have you ever lost your job as a teacher, or as another pedagogue, before achieving tenure?

16.Did you ever receive a discharge from military service for reasons other than an honorable discharge?

Are you now, or were you ever employed by the NYC Department of Education? If yes, indicate dates

17a. ________________________.

17b.

Were you ever fingerprinted by the NYC Department of Education?

Explanation:

Falsifying an employment application is a punishable offense under the Penal Law of New York State.

Signature of person being fingerprinted

Today’s Date

SECTION III: EMPLOYMENT ELIGIBILITY VERIFICATION

COMPLETE

EXEMPT

Signature of Examiner

Signature of Fingerprint Technician

How to Edit Fingerprint Referral Form Online for Free

We were developing this PDF editor with the concept of allowing it to be as easy make use of as it can be. That's why the actual procedure of filling in the nyc doe fingerprinting process is going to be simple use all of these actions:

Step 1: In order to start, click the orange button "Get Form Now".

Step 2: You are now ready to enhance nyc doe fingerprinting process. You possess a wide range of options thanks to our multifunctional toolbar - you can add, erase, or alter the text, highlight the specified elements, as well as carry out several other commands.

Please type in the next information to create the nyc doe fingerprinting process PDF:

part 1 to filling in nyc doe fingerprint referral form

You need to note the required details in the SECTION I BACKGROUND INVESTIGATION, Signature of Referring Official, OfficeDistrict, Telephone Number, SECTION II BACKGROUND QUESTIONS, TODAYS DATE, Month, Day, Year, LAST NAME, SOCIAL SECURITY NUMBER, FIRST NAME, Month, Day, and Year space.

step 2 to completing nyc doe fingerprint referral form

You have to highlight the necessary particulars within the ASIAN INCLUDES ASIAN INDIANS, WHITE Not of Hispanic Origin, STREET ADDRESS, APT NUMBER, CITY, AREA, TELEPHONE NUMBER, EMAIL ADDRESS, STATE, ZIP CODE, FILE NUMBER IF ANY, and FORM box.

Entering details in nyc doe fingerprint referral form stage 3

Identify the rights and responsibilities of the sides inside the paragraph YES, Have you ever been convicted of or, Are any criminal charges, Have you ever been placed on a, Have you ever forfeited bail or, Has a warrant been issued by a, Has a Family Court ever found that, b Are you currently in arrears, Have you ever been discharged, Have you ever been denied, Have you ever resigned or left a, a Has an employer ever brought or, and If yes were you found guilty of.

nyc doe fingerprint referral form YES, Have you ever been convicted of or, Are any criminal charges, Have you ever been placed on a, Have you ever forfeited bail or, Has a warrant been issued by a, Has a Family Court ever found that, b Are you currently in arrears, Have you ever been discharged, Have you ever been denied, Have you ever resigned or left a, a Has an employer ever brought or, and If yes were you found guilty of fields to complete

Finish by reading these fields and filling in the relevant details: Have you ever had any, Have you ever applied for a civil, Have you ever had a teaching, Have you ever received an, Have you ever lost your job as a, Did you ever receive a discharge, Are you now or were you ever, b Were you ever fingerprinted by, Explanation, Falsifying an employment, Signature of person being, Todays Date, SECTION III EMPLOYMENT ELIGIBILITY, COMPLETE, and EXEMPT.

part 5 to entering details in nyc doe fingerprint referral form

Step 3: Press the button "Done". The PDF file is available to be exported. You can easily obtain it to your computer or send it by email.

Step 4: In avoiding probable forthcoming concerns, it's recommended to get at least two or three copies of any document.

Watch Fingerprint Referral Form Video Instruction

Fingerprint Referral Form isn’t the one you’re looking for?

Related Documents

  • Fiorm 3927

    "... The ip Certificate of Adoption state File Number type or print the information in black ink permanent ink parts. Part ii: the Clerk of Court shall sign and attach the certificate information to the vital ..."

  • Fincen Form 109

    "... Previous editions of the 109 March 2011 issue will no longer be accepted. om No 1506 0015 money orders traveler and money transfer money exchange 16 dates or ranges of suspicious activities from mm.dd.yyyyy to ..."

  • Fingerhut Safeline

    "... Dear customer, you've made a wise choice when enrolling in safe line account protection PLUS plan for your web-based fingerhut credit card account. The reverse side of the letter contains the request form for benefits ..."

  • Finra Form 211

    "... Form 211 Part issuer and security information. ..."

Please rate Fingerprint Referral Form

1 Votes

Related Resources

If you believe this page is infringing on your copyright, please familiarize yourself with and follow our DMCA notice and takedown process - click here to proceed .