Form Sfn 53763 – Fill Out and Use This PDF

The SFN 53763 form is an application used by individuals seeking employment with the Bureau of Criminal Investigation (BCI) at the North Dakota Office of Attorney General. It is designed to collect detailed information about the applicant’s background, education, employment history, and other relevant data to assess their eligibility and suitability for the position. If you're considering a career with the BCI and believe you meet the qualifications, click the button below to fill out and submit your SFN 53763 form.

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Form Sfn 53763 PDF Details

In the bustling corridors of career opportunities within the North Dakota Office of Attorney General, the SFN 53763 form emerges as a critical doorway for aspirants aiming to serve as BCI agents. This document, crafted with deliberate attention to detail, serves multiple purposes—it is not only an application for employment but also a testament to the applicant's background, qualifications, and adherence to legal and ethical standards. Candidates are guided through a series of inquiries ranging from basic identification to a comprehensive examination of their educational and employment history, ensuring a thorough understanding of their capability and readiness for the responsibilities entailed. Special emphasis is placed on ensuring applicants meet specific criteria, including veteran's preference and the ability to uphold the rigorous standards expected of those in law enforcement. A review of the applicant's driving and criminal history underscores the importance of integrity and responsibility, vital traits for anyone in this role. Aspiring agents are reminded that the process is underpinned by principles of equality and non-discrimination, in line with both state and federal laws. Thus, the form is not just a procedural hurdle but a foundational step towards a commitment to serve and protect, underscored by a stringent vetting process to ensure only the most qualified and dedicated individuals step forward.

Question	Answer
Form Name	Form Sfn 53763
Form Length	6 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min 30 sec
Other names	sfn53763 nd bci employment form

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					MAIL TO:
		APPLICATION FOR BCI AGENT EMPLOYMENT			MAIL TO:
		APPLICATION FOR BCI AGENT EMPLOYMENT			Office of Attorney General
		NORTH DAKOTA OFFICE OF ATTORNEY GENERAL			600 E Boulevard Ave Dept 125
		SFN 53763 (06-2003)			Bismarck ND 58505-0040
		SFN 53763 (06-2003)

				INSTRUCTIONS
			For assistance in completing this application, please call 701-328-2456.
				IDENTIFICATION

1.	Name (Last, First, Middle)

2.	Present Address			City	State	Zip Code

3.	Home Telephone Number			Work Telephone Number	4. Social Security Number

In compliance with the Federal Privacy Act of 1974, the disclosure of your social security number is voluntary. The social security number is used for record keeping.

5.
DO YOU CLAIM VETERAN'S PREFERENCE?		NO	YES - Attach Report of Separation DD-214
DO YOU CLAIM DISABLED VETERAN'S PREFERENCE?		NO	YES - Attach Current VA Disability Certification and Report of Separation DD-214
	VETERAN ELIGIBILITY: You must be a North Dakota resident and have served in the active military forces during a period of war as established
	in the North Dakota Century Code 37-01-40, or received the armed forces expeditionary or other campaign service medal during an emergency
	condition, and must have been released therefrom under honorable conditions. Applicants claiming veteran's preference must attach a copy of
	REPORT OF SEPARATION DD214. Disabled veterans must also include a letter less than one year old from the Veteran's Administration
	indicating such disability.

6. Did you graduate from high school?		YES		If you are not a high school graduate, do you				NO	YES
	NO	YES		have a GED Equivalency Certificate?				NO	YES
				have a GED Equivalency Certificate?

COLLEGE, UNIVERSITY, NURSING SCHOOL, BUSINESS COLLEGE, VOCATIONAL SCHOOL, OR ANY OTHER SCHOOL YOU HAVE ATTENDED:

				NUMBER OF		FIELD
	NAME AND LOCATION			CREDITS EARNED		FIELD		TYPE OF DEGREE
	NAME AND LOCATION			CREDITS EARNED				TYPE OF DEGREE
				QTR.	SEM.	MAJOR	MINOR



Provide information on education/training you have which is not covered above. Indicate special skills you possess; languages you speak, write or
understand; voluntary and unpaid work experience, etc. Also, list any professional license you currently hold.

		ARREST RECORD
7. Have you ever been charged, posted bond or convicted in court for any traffic or criminal violation of the law in a federal, state, or civil court?
NO	YES-If "YES" - complete details below:

STATE

PLACE

CHARGE

DISPOSITION

SFN 53763 (06-2003) Page 2

8.YOUR EMPLOYMENT HISTORY: Be specific. This information may be used to determine if your application will be accepted. Start with your present, or most recent job. Include armed forces service and any self-employment. Indicate any change of job title under the same employer as a separate position. If you need additional space, attach separate sheets using this same format.

Your Employer		Your duties, responsibilities, size of operation, supervision, etc.

Kind of Business

City	State

Your Title

Name of Your Immediate Supervisor	Title

Full Time	Hours Worked Per Week
Part Time
FROM (Month and Year)	TO (Month and Year)

Beginning Monthly Salary	Ending Monthly Salary	IF STILL EMPLOYED MAY WE CONTACT YOUR EMPLOYER?	YES	NO
		IF STILL EMPLOYED MAY WE CONTACT YOUR EMPLOYER?	YES	NO

Your Employer		Your duties, responsibilities, size of operation, supervision, etc.

Kind of Business

City	State

Your Title

Name of Your Immediate Supervisor	Title

Full Time	Hours Worked Per Week
Part Time
FROM (Month and Year)	TO (Month and Year)

Beginning Monthly Salary	Ending Monthly Salary	IF STILL EMPLOYED MAY WE CONTACT YOUR EMPLOYER?	YES	NO
		IF STILL EMPLOYED MAY WE CONTACT YOUR EMPLOYER?	YES	NO

Your Employer		Your duties, responsibilities, size of operation, supervision, etc.

Kind of Business

City	State

Your Title

Name of Your Immediate Supervisor	Title

Full Time	Hours Worked Per Week
Part Time
FROM (Month and Year)	TO (Month and Year)

Beginning Monthly Salary	Ending Monthly Salary	IF STILL EMPLOYED MAY WE CONTACT YOUR EMPLOYER?	YES	NO
		IF STILL EMPLOYED MAY WE CONTACT YOUR EMPLOYER?	YES	NO

SFN 53763 (06-2003) Page 3

Your Employer

Your duties, responsibilities, size of operation, supervision, etc.

Kind of Business

City

State

Your Title

Name of Your Immediate Supervisor

Title

Full Time

Hours Worked Per Week

Part Time

FROM (Month and Year)

TO (Month and Year)

Beginning Monthly Salary

Ending Monthly Salary

IF STILL EMPLOYED MAY WE CONTACT YOUR EMPLOYER?

YES

Your Employer

Your duties, responsibilities, size of operation, supervision, etc.

Kind of Business

City

State

Your Title

Name of Your Immediate Supervisor

Title

Full Time

Hours Worked Per Week

Part Time

FROM (Month and Year)

TO (Month and Year)

Beginning Monthly Salary

Ending Monthly Salary

IF STILL EMPLOYED MAY WE CONTACT YOUR EMPLOYER?

YES

Do you hold a valid North Dakota Motor Vehicle

YES

Class

Number

Restrictions

Driver's License?

10.

Do you, or have you ever had a motor

YES

If "yes", which state(s)?

Drivers License Number

vehicle driver's license from another state?

11. Have you ever been the driver of a vehicle involved in a

YES

If "yes", list dates and locations of each below.

motor vehicle accident?

SFN 53763 (06-2003) Page 4

12. Have you ever been present where controlled substances such as marijuana, amphetamines, barbituates,	NO	YES

hallucinogenics, hashish, cocaine, opiates, etcetera, were being used?


Explain how many occasions, months and dates of last use.

13.Would you have any reluctance to strictly enforce any and all laws regulating the controlled substances previously mentioned?

YES

14.Have you ever pled or been found guilty of a felony or ever been charged with a felony that was later dismissed under a deferred imposition of sentence?

YES

If yes, explain:

15.Are you now or have you ever been a member of any organization, association, movement, group, or combination of persons which advocates the overthrow of our constitutional form of government, or which has adopted a policy of advocating or approving the commission of acts of force or violence to deny other persons their rights under the Constitution of the United States or the State of North Dakota, or of seeking to alter the form of government of the United States or the State of North Dakota by unconstitutional means?

YES

16.Do you have any objection to a thorough background investigation being made on you, to include copies of your fingerprints being submitted to the FBI for examination?

YES

SFN 53763 (06-2003) Page 5

17. CERTIFICATION AND AGREEMENT: PLEASE READ BEFORE SIGNING

I hereby certify that this application contains no willful misrepresentation or falsification and that the information given by me is true and complete to the best of my knowledge and belief. I am aware that should investigation at any time disclose any such misrepresentation or falsification, my application will be rejected and I may be removed from the job after appointment. I understand that under State and Federal laws, I cannot be discriminated against in employment, including consideration for promotion, for reasons of race, color, religion, national origin, sex, or on the basis of age, physical or mental disability or status with respect to marriage or public assistance. I further understand that this employment application and other employment related documents I may have been furnished are not contracts of employment; also, that any oral or written statements to the contrary are hereby expressly disavowed. The employer has my authorization to thoroughly investigate my work and personal history which is job-related. I certify that I will hold no person, corporation, or organization liable for giving or receiving information in this investigation.

Signature of Applicant:

Date:

ALL INFORMATION IS SUBJECT TO THE NORTH DAKOTA OPEN RECORDS LAW

EQUAL EMPLOYMENT OPPORTUNITY STATEMENT

The North Dakota Office of Attorney General is an equal employment opportunity agency. We do not discriminate on the basis of race, color, national origin, sex, religion, age or disability in employment or the provision of services and complies with the provisions of the North Dakota Human Rights Act.

POLICY OF NON-DISCRIMINATION ON THE BASIS OF DISABILITY

The North Dakota Office of Attorney General does not discriminate on the basis of disability in the admission or access to, or treatment or employment in, its programs or activities. The Administrative Services Commander, NDHP, 600 E. Boulevard, Bismarck, ND 58505 has been designated to coordinate compliance with the non-discrimination requirements contained in section 35.107 of the Department of Justice regulations. Information concerning the provisions of the Americans with Disabilities Act, and the rights provided thereunder, are available from the ADA coordinator.

MAIL APPLICATION TO

Office of Attorney General

600 E Boulevard Ave Dept 125

Bismarck ND 58505-0040

Referral Source

Employment Agency

Attorney General

Employee(s)

Other (Explain)

Television

Poster

Newspaper

Internet

SFN 53763 (06-2003) Page 6

APPLICANT DATA RECORD

(Completion of this form is voluntary)

PLEASE PRINT

Qualified applicants are considered for all positions, and during employment employees are treated without regard to race, color, religion, sex, national origin, age, or marital or veteran status.

As employers, we comply with government regulations and affirmative action responsibilities.

This data is for periodic government reporting and will be kept in a File SEPARATE from the Application for Employment.

Position Applied For:

Application Date:

AFFIRMATIVE ACTION SURVEY

Government agencies require periodic reports on the sex, ethnicity, handicapped, and veteran

status of applicants. These data are for analysis and affirmative action only.

PLACE AN "X" OR CHECK IN THE APPROPRIATE BOXES

Sex

Handicapped

Ethnic Origin

Asian/Pacific

American

Male

Female

Yes

Caucasian

Black

Hispanic

Islander

Indian

Veteran Service

Disabled Veteran

Percent

Surviving Spouse

Yes

Beginning Date

Ending Date

Yes

Disabled

Yes

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Step 1: The following web page contains an orange button saying "Get Form Now". Hit it.

Step 2: Once you've entered the editing page Form Sfn 53763, you'll be able to notice each of the actions intended for the file within the upper menu.

For every single part, add the data demanded by the platform.

Include the demanded data in the box.

Write down the essential data in YOUR EMPLOYMENT HISTORY Be, Your duties responsibilities size, IF STILL EMPLOYED MAY WE CONTACT, YES, Your duties responsibilities size, Your Employer, Kind of Business, City, Your Title, State, Name of Your Immediate Supervisor, Title, Full Time, Part Time, and Hours Worked Per Week field.

The IF STILL EMPLOYED MAY WE CONTACT, YES, Your duties responsibilities size, Name of Your Immediate Supervisor, Title, Full Time, Part Time, Hours Worked Per Week, FROM Month and Year, TO Month and Year, Beginning Monthly Salary, Ending Monthly Salary, Your Employer, Kind of Business, and City City field is the place where all parties can describe their rights and responsibilities.

Fill out the form by taking a look at these sections: Beginning Monthly Salary, Ending Monthly Salary, IF STILL EMPLOYED MAY WE CONTACT, and YES.

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Form Sfn 53763 – Fill Out and Use This PDF

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