The PERS-216 form serves a critical function within the Texas Department of Criminal Justice (TDCJ), delineating a standardized process for applicants, particularly those aiming to become Correctional Officers, to submit necessary documentation. This comprehensive form requires applicants to provide a variety of documents, ranging from identification such as a driver's license and Social Security card, to educational credentials including high school diplomas/GEDs or college transcripts. Significantly, it addresses the need for proper accreditation of foreign education by mandating evaluations through TDCJ-approved services. Additionally, the form encompasses military service verification through the DD Form 214 and mandates proof of Selective Service registration or exemption. For those with a criminal history, it insists on detailed dispositions for each arrest or conviction directly from judicial sources, ensuring a thorough background check. By outlining these requirements, the PERS-216 form underscores the Texas Department of Criminal Justice's commitment to a meticulous vetting process, emphasizing the importance of accuracy and legitimacy in all submitted documents. This form not only facilitates the TDCJ's hiring process but also serves as a critical checkpoint to maintain the integrity and safety standards pivotal to the department's operations.
| Question | Answer |
|---|---|
| Form Name | Form Pers 216 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | pers 216 tdcj missingdocuments fax number form |
Texas Department of Criminal Justice
MISSING DOCUMENT NOTIFICATION
NOTE TO APPLICANTS: With few exceptions, you are entitled upon request: (1) to be informed about the information the Agency collects about you; and (2) under sections 552.021 and 552.023 of the Government Code, to receive and review the collected information. Under section 559.004 of the Government Code, you are also entitled to request, in accordance with the Agency’s procedures, that incorrect information that the Agency has collected about you be corrected.
NAME (Last, First MI)
LOCATION OF INTERVIEW
SOCIAL SECURITY NUMBER
DATE OF INTERVIEW
The following document(s) or information is needed to complete your Correctional Officer application. Please mail or fax to the address below. If not received within 20 days, your application will be inactivated. If necessary, send a letter to the address listed below to request an extension. Include in your letter your social security number and city where you were interviewed.
DRIVERS LICENSE (Copy)
SOCIAL SECURITY CARD (Must be a copy of the card issued to you by the Social Security Office. Sign before copying.)
HIGH SCHOOL DIPLOMA/GED (Copy of diploma from an accredited senior high school or equivalent, or a
HOME SCHOOL AFFIDAVIT (Must be original - Do Not Fax)
(Foreign/international credentials must be evaluated by a
DD FORM 214 Member 4 copy or other copy which includes the Character of Service (e.g., Honorable, General) (www.vetrecs.archives.gov) INCIDENT SUMMARY WORKSHEET # requested: ________
PROOF OF SELECTIVE SERVICE REGISTRATION OR EXEMPTION (Copy) (www.sss.gov)
ADDRESSES (Complete mailing address of references, including zip codes.)
DISPOSITION for each arrest or conviction listed below. (See the important instructions below.)
IMPORTANT
1.Dispositions must be obtained from the judge or clerk of the court having jurisdiction over the case. Dispositions from law enforcement agencies are not acceptable.
2.Dispositions must at least contain the date of arrest and/or conviction, offense and punishment imposed, if convicted. The classification of the offense must also be listed, to include the class of misdemeanors (i.e. A, B or C). If dismissed, the disposition must state the reason for dismissal.
3.When you request a disposition from the court, you must request it with the name you were using at the time of arrest or charge. See aliases below.
4.Dispositions must be on court letterhead or contain a seal if on plain paper and be signed by an official of that Agency.
5.If the court no longer has a record of the case, you must obtain a statement from the court stating such.
6.Dispositions must be sent to us attached to this form. Dispositions written on this form will not be accepted.
Date of Offense |
Name when Charged |
Location |
Type of Offense |
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OTHER:
Signature of Applicant |
Signature of Requesting Official |