Form Dps 688 C PDF Details

Form Dps 688 C is a document used to outline the protection of trade secrets and confidential information. It is most commonly used by businesses that wish to keep this type of information hidden from their competitors. The form provides a detailed explanation of what specific data needs to be kept confidential and how best to protect it. While not foolproof, using Form DPS 688 C can help businesses ensure that their trade secrets remain safe and out of the hands of their rivals.

QuestionAnswer
Form NameForm Dps 688 C
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other names688 c, dps 688, Connecticut, Hgt

Form Preview Example

Department of Emergency Services and Public Protection

AGENCY USE ONLY: Date Received

Division of State Police

 

 

 

Special Licensing and Firearms Unit

 

 

 

 

Employees: Failure to provide complete and accurate information will result in denial.

 

Employers: Incomplete applications will be returned. All applications must be legible.

APPLICATION FOR REGISTRATION OF SECURITY OFFICER

OR PRIVATE INVESTIGATOR

Applicant/Employer Information

Application for registration of employee for:

Security Officer

1.Agency Name

2.Agency Address

Private Investigator

Date

Street

City

State

Zip

3.

Agency Phone (

)

 

 

Agency License Number

4.

On

 

 

I informed the applicant of C.G.S. §§ 29-156a (PI)

 

 

(Day/Month/Year)

 

 

or 29-161q

(SO).

Signature of Licensee or Designee

Print Name/Title

***********************************************************************************************************************************************

SO Identification Card #

Employee Information

5.

Name

 

 

 

 

 

 

Date of Birth

 

 

 

 

 

 

 

 

LAST

FIRST

MIDDLE

 

 

 

 

 

 

 

 

 

 

 

 

6.

Resident Address

 

 

 

 

 

 

 

 

Telephone (

 

 

)

 

 

 

 

 

 

Street

 

City

State

Zip

 

 

 

 

 

7.

Birthplace

 

 

Race:

 

Sex:

 

 

 

Hgt:

 

 

Wgt.:

 

 

City

State

 

8. U. S. Citizen

Yes

No Alien Reg. No.

 

If Naturalized, Where

This information is only required if registration is as a Private Investigator.

9.Describe your experience in the position applied for. If you need additional space, check here and use additional paper.

Date

INCLUDE 2X2 PHOTO WITH AND WITHOUT HEAD COVER

DPS-688-C (REV. 7/11)

1111 Country Club Road, Middletown, CT 06457

 

Telephone: (860) 685-8046 Internet: www.ct.gov/dps

 

An Affirmative Action/Equal Opportunity Employer

10.Previous employment for at least the past five years - include occupation, names, and contact information of employers. If you need additional space, check here and use additional paper.

OCCUPATION

EMPLOYER

ADDRESS

DATES EMPLOYED

TELEPHONE

11. Have you ever been convicted in any court of any crime?

Yes

No

If yes, list all convictions, including charges, location, date of arrest and disposition. Also, list all pending charges,

including nolles within the past 13 months. If you need additional space, check here

and use additional paper.

DATE

CHARGE/VIOLATION

LOCATION (Town/State)

DISPOSTION (Fine/time served/probation)

12. Are you vested with police powers?

Yes

No

I subscribe and affirm under penalties of false statement, that the statements made in this application have been examined by me and to the best of my knowledge and belief are true and correct. I also understand that false statements are punishable in Connecticut pursuant to C.G.S. Section 53a-175b (Class A Misdemeanor) and/or as prescribed in accordance with C.G.S. §§ 29-161, 29-161g, q, x, y, and z inclusive as amended by PA 08- 73 with fines up to $5000 or imprisonment up to one year or both.

STATE OF

 

 

 

 

 

 

Signature of Employee

 

 

 

 

SS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Oath

COUNTY OF

 

 

 

 

 

 

 

 

 

 

APPEARED:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Notary Public, Justice of Peace, Pursuant to C.G.S. 1-24

 

 

 

 

 

 

 

 

 

Commissioner of the Superior Court

ADDRESS:

 

 

 

 

 

 

 

My Commission Expires:

 

 

Subscribed and sworn to before me this

 

day of

, 20

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FOR AGENCY USE ONLY

This application is:

Approved

/ Denied

Date:

Reviewed by:

 

 

 

 

 

 

 

 

 

 

 

Signature

Badge Number

Print Name/Title/Badge Number

BASIS FOR DENIAL:

 

 

 

 

 

 

 

 

 

 

Criminal Record (Felony)

 

 

 

 

Non-conforming/Unclear Photographs

Criminal Record (Misdemeanor)

 

Fingerprint Cards Rejected by S.P.B.I.

Incomplete/Incorrect Information on Fingerprint Cards

 

Other:

Incomplete/Incorrect Information on Application: Item Number(s):

 

 

 

 

 

 

 

DPS-688-C (REV. 7/11)

1111 Country Club Road, Middletown, CT 06457

 

Telephone: (860) 685-8046 Internet: www.ct.gov/dps

 

An Affirmative Action/Equal Opportunity Employer