Pers 283 Form PDF Details

Are you having difficulty understanding the Pers 283 form? If so, don't be alarmed. Many people struggle when trying to figure out how this process works and exactly what is required of them to complete it correctly. In this blog post, we'll look at all the major aspects involved with filling out the Pers 283 form and explain the correct method for doing so in a clear and concise way. We are dedicated to providing detailed information in order for you to successfully understand how this important document can improve your financial standing with military retirement or survivor benefits while also eliminating any confusion or fear that comes along with it.

QuestionAnswer
Form NamePers 283 Form
Form Length5 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 15 sec
Other namestx state pers application online, texas pers application printable, form pers 283, tdcj online application

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THE STATE OF TEXAS

APPLICATION FOR EMPLOYMENT

For State Agency Use Only

Date received __________

Time received __________

Received by ___________

PRINT IN BLACK INK OR TYPE. These instructions must be followed exactly. Fill out application form completely. If questions are not applicable, enter "NA." Do not leave questions blank. Be sure to sign when completed. The State of Texas is an Equal Opportunity Employer and does not discriminate on the basis of race, color, national origin, sex, religion, age or disability in employment or the provision of services. You may make copies of this application and enter different position titles, but each copy must be signed. Resumes will not be accepted in lieu of applications, unless specifically stated in the job vacancy notice. This application becomes public record and is subject to disclosure.

With few exceptions, you have the right to request and be informed about information that the State of Texas collects about you. You are entitled to receive and review the information upon request. You also have the right to ask the state agency to correct any information that is determined to be incorrect. (Reference: Government Code, Sections 552.021, 552.023 and 559.004.)

NAME

 

 

 

 

 

 

 

AC (

)

 

 

(Last)

(First)

 

(Middle)

 

 

 

 

 

 

 

(Daytime Phone)

 

MAILING ADDRESS

 

 

 

 

 

 

 

AC (

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Street)

(City)

(State)

(Zip) ( Country)

(Work Phone, Optional)

 

E-MAIL ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

List any other names used if different from name on this application.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

List exact title of position or type of work and location for which you wish to

 

Job Posting Number

Closing Date

 

apply:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

List the state agency with which you wish to

Do you have any relatives working for this agency? If so, list names and

 

apply:

 

relationships:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Full-Time Part-Time Summer Temp/Project

Are you willing to work hours other than 8-5? Yes

No

Date available for work?

 

Are you at least 17 years of age? Yes

 

 

 

What days are you unable to work?

No

Are you willing to Travel? Yes

No

If yes, what percent of time?

Current Driver's License # (if required for position)

 

 

 

 

Commercial Driver's License Yes

 

 

(State)

(Number)

No

Geographic preference. (Be specific to city/area. If no preference, write "statewide.")

Have you ever been convicted of a felony or subjected to deferred adjudication on a felony charge? Yes

No

If your answer is "Yes,"

explain in concise detail on a separate page, giving dates and nature of the offense, name and location of the court, and disposition of the case(s). A conviction may not disqualify you, but a false statement will. Note: Some state agencies may require additional information related to convictions of misdemeanors.

EDUCATION (NOTE: Applicants may be required to provide proof of diploma, degree, transcripts, licenses, certifications, and registrations.)

High School Graduate or GED? Yes

No

If yes, name and location of high school or GED institute:

Type

 

 

Dates Attended

Date

Expected

Sem/Clock

Type

Major/Minor

of

Name and Location

From

 

To

Graduated

Graduation

Hours

of Diploma

Fields

School

of School

Mo.

Yr.

Mo.

Yr.

 

Date

Completed

or Degree

of Study

Undergraduate

Colleges or

Universities

Graduate

Schools

Technical or

Vocational

Schools

PERS 283 (0909)

Page 1 of 4

AN EQUAL OPPORTUNITY EMPLOYER

If a license, certificate, or other authorization is required or related to the position for which you are applying, complete the following:

 

LICENSE/CERTIFICATION

 

 

Date

 

 

Date

 

 

Issued by/Location of issuing authority

 

 

 

 

 

(P.E., R.N., Attorney, C.P.A., etc.)

 

 

issued

 

 

expires

 

 

(State or other authority) (City & State)

 

 

License No.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Special Training/Skills/Qualifications: List all job related training or skills you possess and machines or office equipment you can use, such as calculators, printing or graphics equipment, computer equipment, types of software and hardware. (Attach additional page, if necessary.)

Approximately how many words per minute do you type?

Sign Language (If required for this position) Yes

No

Do you speak a language other than English? (If required for this position) Yes

If yes, what language(s) do you speak?

Are you a certified interpreter? Yes

No

No

 

 

 

How fluently? Fair

Good

Excellent

Do you write in a language other than English? (If required for this position) Yes

If yes, which language(s)

No

Have you ever been employed by the State of Texas? Yes

No

Are you currently employed by the State of Texas? Yes

If you have been previously employed by the State of Texas, list the agency/agencies:

No

FORMER FOSTER YOUTH (Verification may be required.)

Were you a foster youth under the Texas Department of Family and Protective Services on the day before your 18th birthday? Yes

If yes, are you currently 25 years of age or younger? Yes

No

MILITARY SERVICE (A copy of a report of separation from the Armed Services may be required.)

Are you a veteran? Yes

No

If yes, list type of discharge status

 

 

 

 

Dates of Service (From/To):

 

 

 

 

 

 

 

Are you a surviving spouse of a veteran who has not remarried? Yes

No

Are you a surviving orphan of a veteran? Yes

If yes, complete dates of service for veteran

 

 

 

 

 

No

No

PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY AND INDICATE YOUR

UNDERSTANDING AND ACCEPTANCE BY SIGNING IN THE SPACE PROVIDED

1.I certify that all the information provided by me in connection with my application, whether on this document or not, is true and complete, and I understand that any misstatement, falsification, or omission of information may be grounds for refusal to hire or, if hired, termination.

2.I understand that as a condition of employment, I will be required to provide legal proof of authorization to work in the U.S.

3.I understand that the State of Texas requires all males who are 18 through 25 and required to register with the Selective Service, to present either proof of registration or exemption from registration upon hire.

4.I understand that some state agencies will check with the Texas Department of Public Safety, the Federal Bureau of Investigation or other organizations, for any criminal history in accordance with applicable statutes.

5.I authorize any of the persons or organizations referenced in this application to give you any and all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this application, and I release all such parties from all liability from any damages which may result from furnishing such information to you.

THIS APPLICATION MUST BE SIGNED SIGN HERE: X

Signature – Applicant

Date

PERS 283 (0909)

Page 2 of 4

EMPLOYMENT HISTORY

This information will be the official record of your employment history and must accurately reflect all significant duties performed. Summaries of experience should clearly describe your qualifications.

1.Include ALL employment. Begin with your current or last position and work back to your first. Employment history should include each position held, even those with the same employer.

2.EMPLOYER ADDRESSES MUST BE COMPLETE MAILING ADDRESSES, INCLUDING ZIP CODE.

3.Answer all questions and completely summarize your experience including technical and managerial responsibilities and any special training, skills and qualifications for each position you have held.

If you need additional space to adequately describe your employment history, you may use this employment history sheet or attach a typed employment history providing the same information in the same format as this application form.

Name:

 

 

 

 

 

 

Last

 

 

First

 

Middle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Position Title:

 

 

 

 

 

 

 

 

 

Immediate Supervisor Name:

Full-Time

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer:

 

 

 

 

 

 

 

 

 

 

 

Part-Time

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address:

 

 

 

 

 

 

 

 

 

Title:

 

Summer

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City & State/ZIP:

 

 

 

 

 

 

 

 

 

 

 

Temp/Project

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer’s Telephone No.: AC (

)

 

 

 

 

Supervisor’s Telephone No.:

Give average #

 

 

 

 

 

 

 

Starting Date

 

Leaving Date

Current/

Technical

 

 

AC (

)

of hours worked per

Mo.

Day

 

Yr.

Mo.

 

Day

Yr.

Final Salary

Non-Managerial

 

 

If supervisory, number of employees you

week if part-time:

 

 

 

 

 

 

 

 

 

Supervisory/Managerial

supervised:

 

 

 

 

 

 

 

 

 

 

 

 

Summary of experience including special training/skills/qualifications you have used in the performance of this job:

 

Specific reason for leaving:

 

 

 

 

 

 

 

 

Position Title:

 

 

 

 

 

 

 

 

 

Immediate Supervisor Name:

Full-Time

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer:

 

 

 

 

 

 

 

 

 

 

 

Part-Time

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address:

 

 

 

 

 

 

 

 

 

Title:

 

Summer

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City & State/ZIP:

 

 

 

 

 

 

 

 

 

 

 

Temp/Project

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer’s Telephone No.: AC (

)

 

 

 

 

Supervisor’s Telephone No.:

Give average #

 

 

 

 

 

 

 

Starting Date

 

Leaving Date

Current/

Technical

 

 

AC (

)

of hours worked per

Mo.

Day

 

Yr.

Mo.

 

Day

Yr.

Final Salary

Non-Managerial

 

 

If supervisory, number of employees you

week if part-time:

 

 

 

 

 

 

 

 

 

Supervisory/Managerial

supervised:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Summary of experience including special training/skills/qualifications you have used in the performance of this job:

Specific reason for leaving:

PERS 283 (0909)

Page 3 of 4

Name:

 

 

 

 

 

Last

 

 

First

 

Middle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Position Title:

 

 

 

 

 

 

 

 

Immediate Supervisor Name:

Full-Time

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer:

 

 

 

 

 

 

 

 

 

 

Part-Time

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address:

 

 

 

 

 

 

 

 

Title:

 

Summer

 

 

 

 

 

 

 

 

 

 

 

 

 

City & State/ZIP:

 

 

 

 

 

 

 

 

 

 

Temp/Project

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer’s Telephone No.: AC (

)

 

 

 

 

Supervisor’s Telephone No.:

Give average #

 

 

 

 

 

 

 

Starting Date

Leaving Date

Current/

Technical

 

 

AC (

)

of hours worked per

Mo.

Day

 

Yr.

Mo.

Day

Yr.

Final Salary

Non-Managerial

 

 

If supervisory, number of employees you

week if part-time:

 

 

 

 

 

 

 

 

Supervisory/Managerial

supervised:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Summary of experience including special training/skills/qualifications you have used in the performance of this job:

Specific reason for leaving:

Position Title:

 

 

 

 

 

 

 

 

Immediate Supervisor Name:

Full-Time

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer:

 

 

 

 

 

 

 

 

 

 

Part-Time

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address:

 

 

 

 

 

 

 

 

Title:

 

Summer

 

 

 

 

 

 

 

 

 

 

 

 

 

City & State/ZIP:

 

 

 

 

 

 

 

 

 

 

Temp/Project

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer’s Telephone No.: AC (

)

 

 

 

 

Supervisor’s Telephone No.:

Give average #

 

 

 

 

 

 

 

Starting Date

Leaving Date

Current/

Technical

 

 

AC (

)

of hours worked per

Mo.

Day

 

Yr.

Mo.

Day

Yr.

Final Salary

Non-Managerial

 

 

If supervisory, number of employees you

week if part-time:

 

 

 

 

 

 

 

 

Supervisory/Managerial

supervised:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Summary of experience including special training/skills/qualifications you have used in the performance of this job:

Specific reason for leaving:

PERS 283 (0909)

Page 4 of 4

For State Agency Use Only:

Applicant Number: ________________

APPLICANT EEO DATA FORM

The information requested is optional and is being collected for the purpose of reporting to Federal and Equal Employment Opportunity Agencies and will not be considered as part of the application for employment. It will be separated from the application.

1.

Job Posting Number

2. Last Name (Type or Print)

 

 

First

 

 

Middle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

Address

 

City

 

State

 

 

ZIP Code

 

4. Daytime Phone

5. Work Phone

 

 

 

 

 

 

 

 

 

 

(

)

 

(

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6.

Sex

7. Birth Date

8. Ethnic Origin

 

 

 

 

 

 

 

 

 

 

 

 

M-Male

 

 

 

 

 

 

 

Asian/Pac.

Am. Ind/

 

 

 

F- Female

 

W-White

B-Black

H-Hispanic

P-Islander

I-Alaskan

O-Other

 

 

 

 

 

 

 

 

9.

Veteran

 

10. Surviving Spouse of Veteran

 

 

11. Orphan of Veteran

12. Former Texas Foster Youth

 

 

 

who has not remarried

 

 

 

 

 

 

25 yrs of age or younger

 

Yes

 

Yes

 

 

 

 

Yes

 

 

Yes

 

 

No

 

No

 

 

 

 

No

 

 

 

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13.How did you first find out about this job?

01 - Other State Employee

06 - Newspaper

11 - WorkInTexas.com

02 - Job Fair

07 - College/University Career Day

12 - Other (specify):

03 - Professional Publication

08 - Human Resource/Personnel Office

04 - Recruitment Poster

09 – Radio

05 – Television

10 - Agency Web Site – Internet

X

Signature – Applicant

Date

White (Not of Hispanic origin) – All persons having origins in any of the original peoples of Europe, North Africa, or the Middle East.

Black (Not of Hispanic origin) – All persons having origins in any of the Black racial groups of Africa.

Hispanic – All persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race.

Asian or Pacific Islander – All persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands. This area includes, for example, China, India, Japan, Korea, the Philippine Islands, and Samoa.

American Indian or Alaskan Native – All persons having origins in any of the original peoples of North America, and who maintain cultural identification through tribal affiliation or community recognition.

AN EQUAL OPPORTUNITY EMPLOYER

(0909)

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This PDF form requires specific info to be filled out, therefore you need to take your time to provide exactly what is requested:

1. When submitting the texas pers application pdf, ensure to include all of the necessary blanks in their corresponding part. This will help to facilitate the work, allowing for your information to be handled fast and appropriately.

Writing part 1 in texas pers application printable

2. Now that the previous part is finished, you're ready include the essential specifics in Current Drivers License if, State, Number, Have you ever been convicted of a, EDUCATION NOTE Applicants may be, If yes name and location of high, Name and Location, Dates Attended To, From, Date, Graduated, Expected Graduation, Hours, SemClock, and Type in order to go further.

Stage # 2 in submitting texas pers application printable

3. The following step should be pretty straightforward, LICENSECERTIFICATION, PE RN Attorney CPA etc, Date, issued, Date, expires, Issued byLocation of issuing, License No, Special, Approximately how many words per, Are you a certified interpreter Yes, Do you speak a language other than, If yes what languages do you speak, Do you write in a language other, and If yes which languages - all these form fields will need to be filled in here.

Writing segment 3 of texas pers application printable

4. To go forward, the following section requires completing a couple of blank fields. Examples include FORMER FOSTER YOUTH Verification, Were you a foster youth under the, MILITARY SERVICE A copy of a, If yes list type of discharge, Are you a veteran Yes Dates of, Are you a surviving orphan of a, PLEASE READ THE FOLLOWING, UNDERSTANDING AND ACCEPTANCE BY, I certify that all the information, and THIS APPLICATION MUST BE SIGNED, which you'll find fundamental to continuing with this particular document.

Tips on how to complete texas pers application printable part 4

People often make errors while filling out FORMER FOSTER YOUTH Verification in this section. Be certain to reread what you type in right here.

5. Because you draw near to the last parts of this file, there are a few more points to complete. Notably, THIS APPLICATION MUST BE SIGNED, PERS, Date, and Page of must all be filled out.

texas pers application printable writing process shown (stage 5)

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