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RESTRICTED (when completed)

VETTING FORM

BASIC DETAILS OF APPLICANT

Applicant surname (present)

Applicant forename(s) (present)

Name of post applied for

Department where post is based

Is the applicant currently employed by Northamptonshire Police?

RETURN FORM TO

Name E-mail

INSTRUCTIONS TO APPLICANTS

1 The Chief Constable reserves the right to reject any application without giving reasons.

2 By virtue of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975, the provision of the Rehabilitation of
Offenders Act 1974 does not apply to questions on this form relating to previous convictions. The applicant is,
therefore, not entitled to withhold information about a previous conviction, traffic offence, appearance before a
Courts Martial or juvenile caution, on the grounds that it is, for other purposes, spent under that Act.

***Question 3 is mandatory - DO NOT LEAVE BLANK***


3 Has the applicant ever been convicted, cautioned, arrested, charged, appeared before a Courts Martial or received
any Bind-Over Orders, Traffic Offences or Informal Actions? Does the applicant have any impending prosecutions
or any outstanding matters with any police force? If yes please give particulars in the box below.

***Failure to declare any of the above will result in your application being rejected***

4 NB. Disclosures do not automatically bar the applicant from appointment, each case is considered individually.
However, failure to provide information that comes to light at a later date will result in disciplinary action.

5 If appointed the applicant will be required to provide similar information for Counter Terrorist checks.

6 Northamptonshire Police will access information held on the Police National Computer, National and Local
Intelligence Systems, Financial databases and Residency databases to confirm an applicant's suitability for
employment.

APPLICANT DECLARATION

I hereby declare that all the details I have given on this form are true to the best of my knowledge and belief.

Applicant's signature Date

(19/11/2008) Page 1 of 7
RESTRICTED (when completed)

VETTING FORM

APPLICANT'S FINANCIAL POSITION

Unless otherwise stated, these questions should be completed in respect of the last six years.

YES NO Full details (including dates)


Has the applicant had a loan
arrangement terminated by a bank /
building society / finance house / other?

Has the applicant had a credit / charge /


store card withdrawn?

Is the applicant in arrears with any


existing loan / mortgage / hire purchase
agreement?

Has the applicant ever been registered


as bankrupt?

If the applicant has ever been registered


as bankrupt, have the bankruptcy debts
been discharged?*

Has the applicant had any Court action


taken against them for any debt?

Has the applicant been party to a


voluntary agreement registered with the
County Court?

Has a County Court / Tribunal


Judgement been made against the
applicant?

If the applicant has had a County Court /


Tribunal Judgement made against them,
has this now been cleared?*

Has the applicant had repossession


proceedings commenced against them?

Has the applicant consolidated all their


debts with one lender?

* If applicable, please provide a Certificate of Satisfaction as it is needed before the application can be processed.

(19/11/2008) Page 2 of 7
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VETTING FORM

DETAILS OF APPLICANT

Applicant surname (now) (previous)

Other surnames used (aliases)

Applicant forename(s) (now) (previous)

Applicant gender

Applicant nationality (now) (previous)

Applicant date of birth Applicant place of birth

Applicant current address

Applicant current postcode Resided in current address since (date)

Applicant telephone number

Applicant's previous addresses in the UK for the last 5 years


(INCLUDE DATES OF RESIDENCE FOR ALL PREVIOUS ADDRESSES)

If applicant has lived outside of the UK for 3 months or more in the last 3 years, give addresses and dates of residence
(INCLUDE DATES OF RESIDENCE FOR ALL PREVIOUS ADDRESSES)

(19/11/2008) Page 3 of 7
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VETTING FORM

DETAILS OF APPLICANT (CONTINUED...)

Further comments which affect the applicant's vetting status

(19/11/2008) Page 4 of 7
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VETTING FORM

DETAILS OF RELEVANT OTHER PERSONS

Please complete the following details for these types of people only :

* All persons aged 10 or over residing at the applicant's home address - include all family members / lodgers
/ long-term guests / tenants
* All family members of the applicant aged 16 and over residing elsewhere within the UK - Include parents /
guardians / spouse or partners parents / spouse or partners step-parents/ brothers / sisters / children /
step-relatives / adoptive relatives

OTHER RELEVANT PERSON 1 OTHER RELEVANT PERSON 2


Surname (now)

Surname(s) (prev)

Forename(s) (now)

Forename(s) (prev)

Date of birth

Place of birth

Current address

Relationship to applicant

OTHER RELEVANT PERSON 3 OTHER RELEVANT PERSON 4


Surname (now)

Surname(s) (prev)

Forename(s) (now)

Forename(s) (prev)

Date of birth

Place of birth

Current address

Relationship to applicant

(19/11/2008) Page 5 of 7
RESTRICTED (when completed)

VETTING FORM

DETAILS OF RELEVANT OTHER PERSONS

Please complete the following details for these types of people only :

* All persons aged 10 or over residing at the applicant's home address - include all family members / lodgers
/ long-term guests / tenants
* All family members of the applicant aged 16 and over residing elsewhere within the UK - Include parents /
guardians / spouse or partners parents / spouse or partners step-parents/ brothers / sisters / children /
step-relatives / adoptive relatives

OTHER RELEVANT PERSON 5 OTHER RELEVANT PERSON 6


Surname (now)

Surname(s) (prev)

Forename(s) (now)

Forename(s) (prev)

Date of birth

Place of birth

Current address

Relationship to applicant

OTHER RELEVANT PERSON 7 OTHER RELEVANT PERSON 8


Surname (now)

Surname(s) (prev)

Forename(s) (now)

Forename(s) (prev)

Date of birth

Place of birth

Current address

Relationship to applicant

(19/11/2008) Page 6 of 7
RESTRICTED (when completed)

VETTING FORM

DETAILS OF RELEVANT OTHER PERSONS

Please complete the following details for these types of people only :

* All persons aged 10 or over residing at the applicant's home address - include all family members / lodgers
/ long-term guests / tenants
* All family members of the applicant aged 16 and over residing elsewhere within the UK - Include parents /
guardians / spouse or partners parents / spouse or partners step-parents/ brothers / sisters / children /
step-relatives / adoptive relatives

OTHER RELEVANT PERSON 9 OTHER RELEVANT PERSON 10


Surname (now)

Surname(s) (prev)

Forename(s) (now)

Forename(s) (prev)

Date of birth

Place of birth

Current address

Relationship to applicant

OTHER RELEVANT PERSON 11 OTHER RELEVANT PERSON 12


Surname (now)

Surname(s) (prev)

Forename(s) (now)

Forename(s) (prev)

Date of birth

Place of birth

Current address

Relationship to applicant

(19/11/2008) Page 7 of 7

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