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These instructions are provided for you to properly complete the Personal History Statement. It is essential that the information be accurate in all respects. It will be used as the basis for a background investigation that will determine your eligibility for employment.
1. Your Personal History Statement must be printed legibly in ink by you and no other person. Answer all questions to the best of your ability.
2. If something does not apply, write N/A in the space provided. If it does apply, you are responsible for locating the correct information. Upon completing the form, recheck each section to ensure that all information requested has been provided, or N/A entered if appropriate.
3. Avoid errors by reading the directions carefully before making any entries on the form. Be sure your information is correct and in proper sequence before you begin.
4. Accurate information concerning traffic citations and accidents can be obtained by contacting the driver’s license authority in any state that has issued a license.
5. You are responsible for obtaining correct names, addresses and telephone numbers. If you are not sure of an address or telephone number, check it by personal verification. Your local library may have a directory service or copies of area telephone directories.
6. If there is insufficient space on the form for you to include all information required, attach extra sheets to the Personal History Statement. Be sure to reference the relevant section and question number on the attached sheets.
7. An accurate and complete form will help expedite your investigation. All omissions will be considered willful and may subject you to being passed over on the eligibility list. Any falsification will result in your being passed over on the list.
8. The Authority for Release of Information and Waiver form on the last page MUST be notarized PRIOR to submitting the Personal History Statement.
9. By signing on the line below, I verify that I have read and understand the directions.
List all addresses (including city, county, state and zip code) where you have lived for the past 10 years, beginning with your present address. List dates by month and year. If you were renting, list the name of the landlord or, if you were in an apartment complex, list the name of the complex and the apartment manager’s name. Provide phone numbers for landlords and apartment complexes. Attach extra sheets if necessary.
This field is not part of the form submission.
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