Nc F3 Fillable Form – Fill Out and Use This PDF

The NC F3 form, officially known as the Personal History Statement, is a critical document required by the North Carolina Criminal Justice Education and Training Standards Commission for applicants seeking certification in law enforcement or criminal justice positions. It's structured to comprehensively evaluate an applicant's suitability by encompassing a range of questions from personal history to financial status, ensuring candidates meet the commission's minimum standards for certification. For those looking to begin their certification journey, understanding how to accurately complete this form is essential.

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Nc F3 Fillable Form PDF Details

In the complex landscape of law enforcement and criminal justice certification within North Carolina, the Personal History Statement, known as the NC F3 form, plays a pivotal role. Revised in January 2021 by the North Carolina Criminal Justice Education and Training Standards Commission and the Criminal Justice Standards Division, this document is instrumental in evaluating the eligibility of applicants for certified positions. It is not an initial application for employment; rather, it is a comprehensive questionnaire designed to be completed before the start of a background investigation. The form's sections span personal information, education, marital and family history, residences, financial status, and other areas relevant to assessing an applicant's suitability for certification. The meticulous detail sought, including a requirement for notarization upon completion, underscores the importance placed on truthfulness and accuracy. Incorrect statements or omissions can lead to disqualification or removal from certification consideration. Interestingly, while the form requests a Social Security Number for identification purposes, disclosure is voluntary but failing to provide it may delay processing or lead to inaccuracies in records. Through its various sections, the NC F3 form seeks to ensure that candidates meet the minimum standards for serving in law enforcement and criminal justice roles, reflecting the commission's commitment to maintaining high standards within the field.

Question	Answer
Form Name	Nc F3 Fillable Form
Form Length	17 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	4 min 15 sec
Other names	company police f3, ncf3 police form, nc f3 form, f3 application

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F-3(LE)

Revised 01.21

NORTH CAROLINA CRIMINAL JUSTICE

EDUCATION AND TRAINING STANDARDS COMMISSION

CRIMINAL JUSTICE STANDARDS DIVISION

It is the determination of the Commission that these questions are necessary in order to fully and adequately evaluate applicants for law enforcement and criminal justice certification. These questions are designed to ascertain whether the applicant meets the minimum standards for certification and serve no other purpose.

PERSONAL HISTORY STATEMENT

NOTE: This form is not designed for use as an initial application for employment and must not be used for that purpose. Rather, the applicant for a CERTIFIED position should complete this form prior to beginning his/her background investigation. This form should only be completed by applicants for a Commission- certified position.

NORTH CAROLINA

CRIMINAL JUSTICE EDUCATION AND TRAINING STANDARDS COMMISSION

PERSONAL HISTORY STATEMENT

INSTRUCTIONS: Using the online form or legibly printing in ink fill out this form completely and accurately. If you need extra space, add additional pages and identify the information by item number. If an item does not apply to you, indicate by entering N/A in the blank.

NOTE: All statements are subject to verification and any incorrect statements or omissions may bar or remove you from certification. Truthful statements to any item requested will not necessarily exclude you from consideration.

THIS FORM MUST BE NOTARIZED UPON COMPLETION.

NOTE: The Social Security Number is used to make positive identification of applicant and/or law enforcement personnel. DISCLOSURE IS VOLUNTARY. However, failure to provide this information may result in a delay in the processing of application materials and may result in inaccurate records being assigned to you.

Position(s) applied for:________________________________________________________________________

Agency: _____________________________________					Month: _________		Day: _______	Year: ______
PERSONAL
1.	Name: __________________________________________					2. Social Security Number: ______________
	First		Middle	Last
	Maiden Name:		___________________________________________________________________
	Other Previous Last Names: ________________________________________________________________
	Nicknames or Aliases:		___________________________________________________________________
	Has your name been legally changed after age 12?				Yes	No
	If yes, submit documentation with date and attach to this form.
3.	Present Mailing		____________________________________________________________________
	Address:		Street & Number		City	County	State	Zip Code
	Permanent Mailing		____________________________________________________________________
	Address:		Street & Number		City	County	State	Zip Code
	Telephone Number: ____________________________					______________________________________
	(Include Area Code)		Home				Work
	Cell Phone: ________________________________				Email Address: ______________________________
4.	Date of Birth:_______________________________				5. Place of Birth: _____________________________
6.	Citizenship:	U.S. Born		U.S. Naturalized		Other – Specify	_______________________

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F-3 (LE) Rev. 1/2021

Applicant Name: ______________________________				Agency Applied: ________________________________

	NOTE: Data solicited in this box will be used for Equal Employment statistical purposes only.
7.	Ethnic Background
		American Indian		Spanish American
		Asian American		White
		Black		Other ______________________
8.	Sex	Male	Female

9. Have you previously submitted an application for employment with this agency?

Yes

Approximate Date:_________________________________________________

EDUCATIONAL

10. Indicate below the schools you have attended. (Include incomplete courses)

Indicate the type of High School you attended:
Traditional	Home School
Distance Learning	Did not attend high school		Other: _____________________________

Name		No. Full	When	Graduated	Degree	Major
Address (City & State)		Yrs Work	Attended	(Yes/No)	Awarded	Field
		Completed
High Schools
High Schools


Universities or
Colleges


Extension or
Correspondence
Courses

11. If you did not graduate from high school, have you passed the General Educational Development (GED) Test?

Yes

If yes, when and where did you complete the GED?

_________________________________________________________________________________________

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F-3 (LE) Rev. 01.2021

Applicant Name: ______________________________

Agency Applied: ________________________________

NOTE: Questions included in the next section are intended to assist in the conducting of a background investigation and are not intended for use by the employing agency as disqualifying factors for employment as a criminal justice officer.

MARITAL
12. Marital Status (check one)	Single	Married	Divorced
	Engaged	Separated	Widowed

13. Name of Spouse: _________________________________________________________________________

Name of Former Spouse(s):_________________________________________________________________

________________________________________________________________

14. List all of your children, including any adopted or stepchildren.

Name

(1).

(2).

(3).

(4).

(5).

(6).

Birth Date

Relationship

Address

Phone Number

FAMILY HISTORY

15. Are you related by blood or marriage to any person(s) now employed by this agency?	Yes	No
If yes, give name(s) and details:

_________________________________________________________________________________________

16. Is any member(s) of your immediate family now in prison or on either probation or parole?

Yes

If yes, give name(s) and details:

_________________________________________________________________________________________

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F-3 (LE) Rev. 01.2021

Applicant Name: ______________________________ Agency Applied: ________________________________

RESIDENCES

17. List every city/county in which you have lived since attaining the age of 16, with present address at top:

From	To
Mo/Yr	Mo/Yr	Address of Residence	City County State	Landlord

FINANCIAL

18.What income other than salary do you have at present? ____________________________________________

_________________________________________________________________________________________

19.List all businesses you currently own or have financial interest in (do not list any stocks and bonds): _______

_________________________________________________________________________________________

20.Are you now supporting all children born to you, adopted by you and stepchildren?

Yes

If not, give details: __________________________________________________

_________________________________________________________________________________________

21. Are there persons, other than your spouse and listed children, who are presently dependent upon you for

support?

Yes

If yes, give name and details: ____________________________________

_________________________________________________________________________________________

22.Have you ever been sued with a civil judgment being rendered against you? Please note this includes repossessions, evictions, executions, failure to pay child support, etc. (Do not include divorce)

Yes

Not sure (explain) If yes, give details: _____________________________________

_________________________________________________________________________________________

23.What is the total amount of all your debts at present? $ __________________________________________

24.What is the average monthly total of all of your bills, payments, and current living expenses? $___________

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F-3 (LE) Rev. 01.2021

Applicant Name: ______________________________

Agency Applied: ________________________________

25. List credit references, including creditors to which you make monthly payments:

A.	_________________________________________________	Amount Owing $	________________
	Name of Business
	___________________________________________________________________________________
	Street Address	City and State
B.	_________________________________________________	Amount Owing $	________________
	Name of Business
	___________________________________________________________________________________
	Street Address	City and State
C.	_________________________________________________	Amount Owing $	________________
	Name of Business
	___________________________________________________________________________________
	Street Address	City and State
D.	_________________________________________________	Amount Owing $	________________
	Name of Business
	___________________________________________________________________________________
	Street Address	City and State
E.	_________________________________________________	Amount Owing $	________________
	Name of Business
	___________________________________________________________________________________
	Street Address	City and State
F.	_________________________________________________	Amount Owing $	________________
	Name of Business
	___________________________________________________________________________________
	Street Address	City and State

WORK HISTORY

26.Have you ever been denied employment by a law enforcement agency, corrections agency, or security agency which required certification or licensure from any Commission, Board or Agency after a conditional

offer of employment was made?

Yes

If yes, list agency name and give details: _________________________________

_________________________________________________________________________________________

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F-3 (LE) Rev. 01.2021

Applicant Name: ______________________________

Agency Applied: ________________________________

27.Have you ever held a position in any capacity which required certification or licensure from any Commission, Board or Agency established to certify or license that position? (Note: List any such Commission, Board, or

Agency, whether in or out of North Carolina.) Yes No

27a. If yes, was such certification or license ever suspended, revoked, or any sanctions taken against it

by the issuing authority?

Yes

27b. If such certification or license was ever suspended, revoked, or any sanctions taken against it by the issuing authority, please list the agency’s name taking the action against the certification or license, date of the action, reason for the action, and the period of time for the suspension, revocation, or sanction. ______________________________________________________

_________________________________________________________________________

28.Have you ever been discharged, requested to resign, or allowed to resign in lieu of termination, from any position because of criminal or personal misconduct or rules violations?


	Yes	No	If yes, list organization name and give details: _____________________________
	__________________________________________________________________________________
	__________________________________________________________________________________
	__________________________________________________________________________________
29.	Do you object to wearing a uniform?			Yes	No
30.	Do you object to working nights?			Yes	No
31.	Do you object to working rotating shifts?			Yes	No
32.	Do you object to occasionally being away from home overnight and for other periods of time attending
	meetings, acquiring training and otherwise performing official duties?					Yes	No

33.List ALL jobs, positions or appointments you have held in the last ten years to include temporary, part-time, paid or not paid employment, active or inactive reserve, and internships. Put your present or most recent job first. List a Reason for Leaving for each job. Include military service in proper time sequence and temporary part-time jobs. If there are gaps in your employment please provide an explanation for each period of unemployment.

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F-3 (LE) Rev. 01.2021

Applicant Name: ______________________________ Agency Applied: ________________________________

A. Title of present or last position ________________________________________________________

Employer Address and Phone Number __________________________________________________

NamePhone Number

_________________________________________________________________________________

Street	City	State	Zip Code
Date Employed _____________	Starting Salary		__________ Last Salary
Date Separated______________	Name/Title of Supervisor _____________________
Full Time __ Yrs____ Mos	Part Time ____	Yrs	Mos
If part time, number of hours worked per week ______		No. employees supervised by you _

Duties: ___________________________________________________________________________

_________________________________________________________________________________

Reason for leaving: ________________________________________________________________

______________________________________________________________________________________

B. Title of present or last position ________________________________________________________

Employer Address and Phone Number __________________________________________________

NamePhone Number

_________________________________________________________________________________

Street	City	State	Zip Code
Date Employed _____________	Starting Salary		__________ Last Salary
Date Separated______________	Name/Title of Supervisor _____________________
Full Time __ Yrs____ Mos	Part Time ____	Yrs	Mos
If part time, number of hours worked per week ______		No. employees supervised by you _

Duties: ___________________________________________________________________________

_________________________________________________________________________________

Reason for leaving: ________________________________________________________________

______________________________________________________________________________________

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F-3 (LE) Rev. 01.2021

Applicant Name: ______________________________ Agency Applied: ________________________________

C. Title of present or last position ______________________________________________________

Employer Address and Phone Number __________________________________________________

NamePhone Number

_________________________________________________________________________________

Street	City	State		Zip Code
Date Employed _____________		Starting Salary		__________ Last Salary
Date Separated______________		Name/Title of Supervisor _____________________
Full Time __ Yrs____ Mos	Part Time ____		Yrs	___________________ Mos
If part time, number of hours worked per week ______			No. employees supervised by you _

Duties: ___________________________________________________________________________

_________________________________________________________________________________

____________________________________________________________________________________

Reason for leaving:___________________________________________________________________

______________________________________________________________________________________

D. Title of present or last position _________________________________________________________

Employer Address and Phone Number __________________________________________________

NamePhone Number

_________________________________________________________________________________

Street	City	State		Zip Code
Date Employed _____________		Starting Salary		__________ Last Salary
Date Separated______________		Name/Title of Supervisor _____________________
Full Time __ Yrs____ Mos	Part Time ____		Yrs	___________________ Mos
If part time, number of hours worked per week ______			No. employees supervised by you _

Duties: ___________________________________________________________________________

_________________________________________________________________________________

Reason for leaving:

__________________________________________________________________________________

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F-3 (LE) Rev. 01.2021

Applicant Name: ______________________________ Agency Applied: ________________________________

E. Title of present or last position ________________________________________________________

Employer Address and Phone Number __________________________________________________

NamePhone Number

_________________________________________________________________________________

Street	City	State		Zip Code
Date Employed _____________		Starting Salary		__________ Last Salary
Date Separated______________		Name/Title of Supervisor _____________________
Full Time __ Yrs____ Mos	Part Time ____		Yrs	___________________ Mos
If part time, number of hours worked per week ______			No. employees supervised by you _

Duties: ___________________________________________________________________________

_________________________________________________________________________________

Reason for leaving: ________________________________________________________________

__________________________________________________________________________________

F. Title of present or last position ________________________________________________________

Employer Address and Phone Number __________________________________________________

NamePhone Number

_________________________________________________________________________________

Street	City	State		Zip Code
Date Employed _____________		Starting Salary		__________ Last Salary
Date Separated______________		Name/Title of Supervisor _____________________
Full Time __ Yrs____ Mos	Part Time ____		Yrs	___________________ Mos
If part time, number of hours worked per week ______			No. employees supervised by you _

Duties: ___________________________________________________________________________

_________________________________________________________________________________

Reason for leaving: _________________________________________________________________

_______________________________________________________________________________________

G.Explain Periods of unemployment of three months or more. _________________________________

__________________________________________________________________________________

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F-3 (LE) Rev. 01.2021

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Step 2: At this point, you can begin modifying your f 3 form. The multifunctional toolbar is at your disposal - insert, remove, change, highlight, and conduct similar commands with the content in the document.

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Write the information in Permanent Mailing Address, Street Number, City, County, State, Zip Code, Telephone Number Include Area Code, Home, Work, Cell Phone Email Address, Date of Birth Place of Birth, Citizenship, US Born, US Naturalized, and Other Specify.

company police f3 Permanent Mailing Address, Street Number, City, County, State, Zip Code, Telephone Number Include Area Code, Home, Work, Cell Phone Email Address, Date of Birth Place of Birth, Citizenship, US Born, US Naturalized, and Other Specify blanks to complete

You should be required some important details to be able to complete the Applicant Name, Agency Applied, NOTE Data solicited in this box, Ethnic Background, American Indian Asian American, Sex, Male, Female, Spanish American White Other, Have you previously submitted an, Yes, Approximate Date, EDUCATIONAL, Indicate below the schools you, and Indicate the type of High School area.

company police f3 Applicant Name, Agency Applied, NOTE Data solicited in this box, Ethnic Background, American Indian Asian American, Sex, Male, Female, Spanish American White Other, Have you previously submitted an, Yes, Approximate Date, EDUCATIONAL, Indicate below the schools you, and Indicate the type of High School blanks to insert

The area Name Address City State, No Full Yrs Work Completed, When Attended, Graduated YesNo, Degree Awarded, Major Field, High Schools, Universities or Colleges, Extension or Correspondence Courses, If you did not graduate from high, Yes, and If yes when and where did you will be where to add each side's rights and obligations.

Review the sections Applicant Name, Agency Applied, NOTE Questions included in the, MARITAL Marital Status check one, Single, Engaged, Married, Separated, Divorced, Widowed, Name of Spouse, Name of Former Spouses, and List all of your children and then fill them out.

company police f3 Applicant Name, Agency Applied, NOTE Questions included in the, MARITAL Marital Status check one, Single, Engaged, Married, Separated, Divorced, Widowed, Name of Spouse, Name of Former Spouses, and List all of your children blanks to fill

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