Navigating the landscape of pre-employment requirements in Tennessee’s correctional institutions involves understanding a crucial document: the IN-0055 form. This form serves as a waiver request from specific pre-employment prerequisites outlined in T.C.A. § 41-4-144. It is designed for applicants seeking positions within the Tennessee Corrections Institute, focusing primarily on those who might not meet certain criteria due to past military service, criminal violations, or other factors that typically disqualify a candidate. The process acknowledges the importance of full disclosure, requiring applicants to indicate their criminal history, if any, including minor offenses. More importantly, it outlines the circumstances under which the Board of Control may consider granting a waiver, such as cases involving Entry Level Separations or General Discharges under Honorable Conditions from military service, and misdemeanor violations. Completing this form accurately is not just a matter of administrative procedure; it's a matter of legal integrity, as providing false information can lead to charges of perjury. Applicants are reminded of the necessity to attach supporting documents, such as psychological evaluations and military discharge papers, which play a pivotal role in the waiver's approval process. This form, therefore, is not merely a bureaucratic hurdle but a gateway to potential employment for those whose past might not fully reflect their current capabilities and character.
| Question | Answer |
|---|---|
| Form Name | Form In 0055 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | IN 0055 Waiver of Pre employment Requirements Rev 1 13 tci waiver form tn |
STATE OF TENNESSEE
TENNESSEE CORRECTIONS INSTITUTE
WAIVER OF
T.C.A. §
Date of Request: ____________________ Department: ___________________________________________________
Applicant Name: _____________________________________________________
Social Security Number: ____________________________ Date of Birth: ________________________________
Military Service: Yes ___ No ___ Date of Discharge: ____________________ Type of Discharge: ____________________
_______________________________________ |
_____________________________________________ |
Signature of Law Enforcement Agency Head |
Print/Type Name of Agency Head |
__________________________________________________________________________________________________
The applicant has not been convicted of or pleaded guilty to or entered a plea of nolo contendere to any felony charge or to any violation of any federal or state laws or city ordinances relating to force, violence, theft, dishonesty, gambling, liquor, or controlled substances. The applicant has not been released or discharged under any other than honorable discharge from any of the armed forces of the United States.
Has the applicant ever been convicted of any criminal violation? |
Yes ___ |
No ___ |
Has the applicant ever been convicted of anything other than a traffic violation |
Yes ___ |
No ___ |
Has the applicant ever been convicted of driving under the influence? |
Yes ___ |
No ___ |
(If the answer to any of these questions is yes, attach a full explanation including date, location, charge(s), disposition, court, and the law enforcement agency having jurisdiction. If yes, and the charges have been dismissed, please attach a copy of the court document.)
The Board of Control may consider a waiver from
Any person who, with intent to deceive, makes any false statement on this document commits the offense of perjury pursuant to T.C.A.
_______________________________________ |
____________________ |
Signature of Applicant |
Date |
THE FOLLOWING DOCUMENTS MUST BE ON FILE AT THE EMPLOYING AGENCY AND READILY AVALIABLE FOR INSPECTION BY ANY BOARD OF CONTROL REPRESENTATIVE OR CORRECTIONS INSTITUTE INSPECTOR.
Copy of Application for Waiver
Original Confidential Psychological Evaluation
Copies of all Military
For TCI Use Only
RDA 2884 |