Form 12333 PDF Details

Navigating the prerequisites for federal employment can appear daunting, primarily when it involves understanding specific forms like the 12333 form. This pivotal document, utilized mainly within the sphere of government agencies, serves a dual purpose: it is a consent for a fingerprint check and a brief but comprehensive agreement to permit background investigations. It is designed to ensure that candidates for employment or those in certain sensitive positions undergo a thorough vetting process, involving the collection and analysis of their fingerprints against criminal databases. Through this form, applicants authorize investigators or other representative bodies of federal agencies to acquire any criminal history record information that may exist in federal, state, or local criminal justice systems. Moreover, it highlights the role of the Privacy Act Statement of 1974 in safeguarding the applicant's rights by detailing the legal framework, purpose of data collection, and potential implications of non-disclosure. The form also intricately outlines the process for live scan screening, requiring detailed personal information and specific requirements for the position applied for, thereby establishing a seamless procedure for determining an individual's suitability for federal employment. This in-depth approach underscores the government's commitment to ensuring the integrity and reliability of its workforce, reflecting on the significant weight the 12333 form holds in the federal employment application process.

QuestionAnswer
Form NameForm 12333
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesussid 18, irs pdf fillable forms, irs forms fillable pdf, fillable pdf forms irs

Form Preview Example

Consent For Fingerprint Check

Part A

I hereby authorize any investigator, special agent, or other duly appointed representative of the authorized Federal agency conducting my background investigation to receive any criminal history record information pertaining to me, which may be in the files of any Federal, state or local criminal justice agency. I understand my fingerprint form may be provided to other Federal, state or local agencies in conjunction with the application process, and I consent to such disclosure.

Name (Last, first, middle initial) (Please print)

Home phone number

Signature

You must sign here

Social Security Number

Date

Privacy Act Statement

The Privacy Act Statement of 1974 requires that when we ask you for information, we state our legal right to do so, why we are asking for the information, and how it will be used. We must also tell you what could happen if you do not provide it and whether your response is voluntary, required to obtain a benefit or mandatory.

Our legal right to ask for the information is 5 USC 301, and Executive Order 9397. We are asking for this information to investigate your background and determine your suitability for employment.

Disclosure of the information may be made to Federal, state and local agencies, and judicial authorities as authorized by law. Violations or potential violations of law, whether civil, criminal or regulatory in nature may be reported to appropriate agencies that have the responsibility for investigating or prosecuting such violations or are charged with enforcing or implementing such laws.

Your failure to complete the pre-appointment/post-appointment information on this form may mean that the required information cannot be obtained to determine your suitability and/or conduct an investigation. Without this information, a determination as to your suitability for Federal employment cannot be made and may result in you not being considered for employment; or a determination may be made that you are unsuitable for your position.

Part B

Live Scan Screen Information

 

 

Name (Last, First, Middle) (Please spell out complete full Legal Name)

Middle Name (Full Legal Middle Name. Do not use initials. If no middle name, indicate by printing "NMN".

Maiden Name should be listed in Aliases block)

Last name

 

 

First name

 

 

Middle name

 

 

 

 

 

 

 

 

 

Social Security Number

Date of birth (mm/dd/yyyy)

 

Position applying for:

 

 

 

 

 

 

 

 

 

Clerk

Revenue Agent

 

 

 

 

 

 

 

Data Transcriber

TRR/TSS

 

 

 

 

 

 

 

 

 

Aliases (for example maiden name or other last names used)

 

Sex

 

Tax Examiner

Other (specify)

 

 

 

 

 

Male

Female

Contact

 

 

 

 

 

 

 

Representative

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Race

 

 

Eye color (excluding colored contacts)

Hair color

 

 

A - Asian

W - White/Latino

BLK - Black

HAZ - Hazel

BAL - Bald

RED - Red

B - Black

U - Unknown

BLU - Blue

MAR - Maroon

BLK - Black

SDY - Sandy

I - Indian (Native American, Eskimo)

BRO - Brown

PNK - Pink

 

BLN - Blond

WHI - White

 

 

 

GRN - Green

XXX - Unknown

BRO - Brown

XXX - Unknown

 

 

 

GRY - Gray

 

 

GRY - Gray

 

 

 

 

 

 

 

 

Height (feet and inches)

Weight (pounds)

Place of Birth (City, State, Country - if born in Mexico or Canada include state or

 

 

 

province where born)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Resident address (street number and name; do not use P.O. Box)

 

 

 

 

 

City

State

ZIP code

Form 12333 (Rev. 7-2011)

Catalog Number 28289L

publish.no.irs.gov

Department of the Treasury-Internal Revenue Service

Security Entry and Tracking System (SETS) Activity Log

 

(For Personnel Office Use Only)

 

 

Name (Applicant/Employee)

Reason for fingerprinting*

 

 

EOD (or date entered new position)

POD

Business Unit (i.e. AWSS, SBSE, WAGE, etc.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Live Scan number

 

Ink and Roll

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SOI

SON

 

* If courtesy print - please FAX servicing personnel

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

office consent form within 24 hours

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fingerprints

 

 

Forms

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Entered into Live

 

 

 

 

Entered into

 

 

 

 

Action

 

 

 

 

 

Date

Scan or SETS

Action

 

Date

SETS

 

 

 

 

 

 

 

 

 

 

 

 

 

(EE initials)

 

 

 

 

(EE initials)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FP Taken by:

 

 

 

 

 

 

 

 

 

 

 

 

EE Name

 

 

 

 

 

 

 

 

Investigation package EE

 

 

 

SOI

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Returned by EE

 

 

 

FP Taken by Courtesy Personnel

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Office:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EE Name

 

 

 

 

 

 

 

 

Follow-up (if applicable)

 

 

 

SOI

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Review by QR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BIO entered into live scan by

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SETS Applicant Record Built

 

 

 

 

 

 

 

Investigation initiated

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Transmitted/Mailed

 

 

 

 

 

 

 

and type of investigation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SETS update not allowed

 

 

 

 

 

 

 

Return unaccept

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Returned

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Resubmitted

 

 

 

Resubmitted

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CCT Received

 

 

 

 

 

 

 

Investigation complete/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Prior Investigation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

New investigation not required

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

 

 

 

 

 

 

 

Comments

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Form 12333 (Rev. 7-2011)

Catalog Number 28289L

publish.no.irs.gov

Department of the Treasury-Internal Revenue Service

How to Edit Form 12333 Online for Free

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As for the fields of this precise document, here's what you should do:

1. To begin with, once filling in the consent fingerprint, beging with the page that features the following blank fields:

Step # 1 for filling in fingerprinting gov irs form

2. Your next part is usually to complete the next few blank fields: Social Security Number, Date of birth mmddyyyy, Position applying for, Aliases for example maiden name or, Sex, Clerk, Revenue Agent, Data Transcriber, TRRTSS, Tax Examiner Contact Representative, Other specify, Male, Female, Race, and Eye color excluding colored.

Step number 2 in filling in fingerprinting gov irs form

As to Eye color excluding colored and Data Transcriber, make certain you do everything right here. These are thought to be the most important fields in the form.

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