In a landscape where professionalism and accountability within law enforcement are of paramount importance, the CJ1902 form serves as a crucial mechanism for maintaining integrity and trust. Revised on August 21, 2012, and guided by the legal frameworks of RCW 43.101.135 & RCW 43.101.157, this Notice of Officer Separation form demands timely and accurate reporting of any law enforcement officer's separation from service to the Washington State Criminal Justice Training Commission (WSCJTC) within a stringent 15-day window. It specifies a submission process through fax or email, underscoring the value placed on efficiency and reliable communication. The detailed requirements call for typing all information except for signatures, ensuring clarity and legibility. Crucially, the form encompasses a variety of separation circumstances ranging from retirement in good standing to dismissals tied to disqualifying misconduct, including convictions under certain conditions, dishonesty, unlawful substance use, or the inability to legally possess firearms. The legislation identifies the necessity for agencies to declare awareness of any conduct that may qualify as disqualifying misconduct, demanding a response that evidences an officer's departure, whether voluntary or involuntary, was scrutinized for such infractions. By mandating comprehensive reporting, including the officer’s last known contact information and an agency investigative contact, the CJ1902 form embodies a systematic approach to uphold standards within the law enforcement community, providing a measure to potentially revoke credentials based on substantiated misconduct.
| Question | Answer |
|---|---|
| Form Name | Form Cj1902 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | notice of peace officer separation of service, ohio opota form sf401, sf401adm forms, fillable sf401 |
NOTICE OF OFFICER SEPARATION
FORM CJ1902
REVISED 08/21/2012
IN ACCORDANCE WITH RCW 43.101.135 & RCW 43.101.157
THIS FORM MUST BE SUBMITTED TO THE WSCJTC WITHIN 15 DAYS OF SEPARATION.
WE REQUEST THAT YOU SEND THIS FORM BY FAX OR EMAIL.
QUESTIONS: 206‐835‐7332 |
FAX: 206‐835‐7923 |
EMAIL: tjones@cjtc.state.wa.us |
With the exception of the signature box, this form must be typed.
AGENCY:
RANK:
PEACE OFFICER’S FULL NAME:
Female
Male
DATE OF BIRTH (MM/DD/YY):
HIRE DATE (MM/DD/YY):
SOCIAL SECURITY NUMBER:
SEPARATION DATE (MM/DD/YY):
REASON FOR SEPARATION:
Retired, in good standing |
|
Resigned, in good standing |
|
|
Terminated, involuntary |
|
Medical |
|
|
Deceased |
||||
|
|
Resigned, in anticipation of termination |
|
|
Retired, in anticipation of termination |
|
||||||||
|
|
|
|
|
||||||||||
Laid off
Is this agency aware of conduct that may fall under the meaning of “Disqualifying Misconduct” as defined below:
RCW 43.101.010
(7)A peace officer is "convicted" at the time a plea of guilty has been accepted, or a verdict of guilty or finding of guilt has been filed, notwithstanding the pendency of any future proceedings, including but not limited to sentencing, post trial or post fact‐finding motions and appeals. "Conviction" includes a deferral of sentence and also includes the equivalent disposition by a court in a jurisdiction other than the state of Washington.
(8)"Discharged for disqualifying misconduct" means terminated from employment for: (a) Conviction of (i) any crime committed under color of authority as a peace officer, (ii) any crime involving dishonesty or false statement within the meaning of Evidence Rule 609(a), (iii) the unlawful use or possession of a controlled substance, or (iv) any other crime the conviction of which disqualifies a Washington citizen from the legal right to possess a firearm under state or federal law; (b) conduct that would constitute any of the crimes addressed in (a) of this subsection; or (c) knowingly making materially false statements during disciplinary investigations, where the false statements are the sole basis for the termination.
(9)A peace officer is "discharged for disqualifying misconduct" within the meaning of subsection (8) of this section under the ordinary meaning of the term and when the totality of the circumstances support a finding that the officer resigned in anticipation of discipline, whether or not the misconduct was discovered at the time of resignation, and when such discipline, if carried forward, would more likely than not have led to discharge for disqualifying misconduct within the meaning of subsection (8) of this section.
(MUST CHECK YES OR NO)
YES
NO
RCW 43.101.135 requires the agency of termination, to provide such documentation or information as the commission deems necessary and requests to investigate and determine whether the separation provides grounds for revocation under RCW 43.101.105.
Employee’s last known mailing address, email address, and phone number:
Agency investigative contact person (Name, title, phone number, and email):
I declare under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct to the best of my knowledge.
Appointing official (name, title, phone and email:
Signature of above
Date
FOR WSCJTC USE ONLY
Date entered into LMS: