In the state of Ohio, the process of managing peace officer appointments and terminations is streamlined through the use of a specific form, known as the Sf400Adm. This document serves a critical role in ensuring that the Ohio Peace Officer Training Commission (OPOTC) maintains accurate records of all peace officers' employment statuses within the jurisdiction. The form covers a wide array of circumstances including new appointments, changes in appointment status (such as moving from reserve to full or part-time positions), terminations, and even corrections to previously filed records, like name changes. Importantly, it acts as a conduit for personal information, which is handled with confidentiality and security as outlined by the Federal Privacy Act. This law mandates the transparent collection of personal details for the purpose of recording training, affiliations, and testing results while stipulating stringent guidelines for the disclosure of sensitive information such as Social Security Numbers. Officers and appointing agencies are required to fill out and submit this form within 10 days of any reportable action to adhere to Ohio Revised Code 109.761, emphasizing the form's role in maintaining timely and accurate personnel records. The sections of the Sf400Adm demand detailed information about the officer and the appointing agency, specifics of the appointment or termination, and a formal attestation by the reporting official, underscoring the document's comprehensive nature and its essential function in the administrative landscape of Ohio's law enforcement.
| Question | Answer |
|---|---|
| Form Name | Sf400Adm Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | ohio sf400 form, ohio sf400 pdf form, sf400 notice of peace officer appointment, ohio ag peace officer appointment form |
OHIO PEACE OFFICER
TRAINING COMMISSION
NOTICE OF PEACE OFFICER APPOINTMENT/TERMINATION (mark appropriate box)
Appointment
Appointment Status Change (e.g., reserve to full/parttime)
Termination
Correction to Record - highlight correction(s)
Personal Information Disclosure Statement - Pursuant to the Federal Privacy Act (Public Law
INSTRUCTIONS
•Completion of this Notice form is required within 10 days of appointment or termination for all peace officers as defined in ORC 109.71(A).
•Use this Notice to report new appointments, appointment status changes, corrections (including name changes), and terminations.
•Sections A, B, and E must be completed, then complete Section C and pages 2 and 3 or Section D as appropriate.
•Please type or legibly print (in ink) all required information.
•Mail or fax this Notice to OPOTC at the below address within 10 days of such actions, as required by Ohio Revised Code 109.761.
A. OFFICER INFORMATION
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SOCIAL SECURITY NUMBER |
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NAME (Last) |
(First) |
(Middle) |
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3. BIRTHDATE (mm/dd/yyyy) |
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4. |
GENDER |
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ALIAS (Last) |
(First) |
(Middle) |
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6. HOME PHONE NUMBER |
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Female |
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7. DRIVER’S LICENSE # |
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HOME STREET/MAILING ADDRESS (#/Street/PO Box) |
(City) |
(County Name) |
(State) |
(Zip Code) |
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B. AGENCY INFORMATION
9. AGENCY NAME |
10. APPOINTING AUTHORITY’S NAME & TITLE |
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11. AGENCY PHONE NUMBER |
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12. AGENCY STREET/MAILING ADDRESS (#/Street/PO Box) |
(City) |
(County Name) |
(State) |
(Zip Code) |
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C. APPOINTMENT INFORMATION
13. |
APPOINTMENT DATE (mm/dd/yyyy) |
14. CURRENT RANK |
15. |
TITLE/ POSITION |
16. ORC SECTION |
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APPOINTMENT STATUS (mark appropriate box) |
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APPOINTEE’S FIRST PEACE OFFICER APPOINTMENT? |
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Full Time |
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Part Time |
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Auxiliary |
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yes |
(Complete all of page 2) |
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Reserve |
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Special |
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no |
(Complete pages 2 and 3 – an update evaluation will occur) |
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D. TERMINATION INFORMATION
19. TERMINATION DATE (mm/dd/yyyy)
20. REASON FOR TERMINATION (mark appropriate box)
Resigned |
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Discharged |
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Retired |
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Deceased |
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Felony Conviction |
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Other |
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E. ATTESTATION OF REPORTING OFFICIAL
I attest that the information provided on this form is true and correct and is based on my personal knowledge or inquiry. The personnel records of this agency substantiate the information on this form.
SIGNATURE OF REPORTING OFFICIAL |
NAME & TITLE OF REPORTING OFFICIAL (Typed or Printed Legibly) |
DATE |
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SF400adm
Effective 2/20/2002; Revised 12/20/2004
Page 1 of 3
P.O. BOX 309/LONDON, OHIO 43140 PHONE: (740)