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NPPV LEVEL 2
SECURITY VETTING FORM
WORK EXPERIENCE
The information required on this form will enable an assessment to be made as to the suitability of the
applicant to gain access to police assets by way of undertaking appropriate checks of the data subject,
relatives, guardians, and any individuals necessarily identified in the course of police enquiries. The checks
will be undertaken by accessing national and local police systems, and financial information in order to
establish any issues relating to past cautions, convictions, family, lifestyle, financial and social circumstances.
The personal data supplied will be managed confidentially, securely and in accordance with the Data
Protection Act 1998. Personal data will be retained in accordance with retention periods established through
the national guidance on Management of Police Information, where after it will be disposed of securely. Under
the Data Protection Act, individuals have a general right of access to personal data held by police forces. The
data controller for the information collected by completion of this form is the Chief Constable.
Authentication of applicant’s identity
Documents checked (Driving licence, Birth Certificate, Passport and Utility Bill (or mobile phone bill) in your
name) by employer: Yes* / No* *Please delete as appropriate
SIGNED: _________________________________________ DATE ____________________________
Name: ________________________ Position in Force / Company:______________________________
To be completed by applicant. Failure to complete all the sections could delay your application.
Your personal details will NOT be released to any other individuals or company, other than another Police
force without your approval. It is your responsibility to inform the individuals listed. All questions to be
completed. Where a question is not applicable or the answer is not known, please enter N/A or N/K. Use
extra pages as required.
APPLICANT
N.I. Number:
Title:
Surname:
Forenames:
Maiden / Former Name(s):
Male / Female:
Date of Birth:
Place of Birth:
Address:
Previous address: (Addresses to cover five
years):
Postcode:
Since:
Telephone Number:
Email address:
Name of School / College:
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PARENTS DETAILS
Please enter details of your natural parents including adoptive parents, stepparents or guardians.
FATHER
MOTHER
Surname inc. any other surnames:
Surname inc. any other surnames (Maiden
Name(s)):
Forenames:
Forenames:
Date of Birth:
Date of Birth:
Place of Birth inc Town / City
Place of Birth inc Town / City
Address:
Address:
Postcode
Postcode:
Since:
Since:
If deceased please give Date:
If deceased please give Date:
BROTHERS AND SISTERS DETAILS
Please enter details of your brothers and sisters, including half/adopted or stepbrothers and half/adopted
or step sisters. There is no need to include brothers and sisters under 10 years of age.
Since:
Since:
If deceased please give Date:
If deceased please give Date:
Relationship:
Relationship:
Surname inc. any other surnames
Surname inc. any other surnames
Forenames:
Forenames:
Date of Birth:
Date of Birth:
Place of Birth inc Town / City
Place of Birth inc Town / City
Address:
Address:
Postcode:
Postcode:
Since:
Since:
If deceased please give Date:
If deceased please give Date:
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FINANCIAL DETAILS
Please answer the following:
Yes*
No
Have you been party to a voluntary agreement registered with the County Court, or a
Sheriffs’ Court or Court of Session judgement in Scotland?
Have you been subjected to a County Court judgement / Bankruptcy order or
Voluntary arrangements?
Have you been subjected to termination of credit card / bank account / attachment of
earnings order repossession proceedings against you?
Do you have any secondary employment or business interests, or any financial
interests that may conflict with your employment with your company and/or Police
Authorities?
*If yes please describe below:
(please continue on a separate sheet if necessary)
_______________________________________________________________________________________
_______________________________________________________________________________________
SECURITY INFORMATION
1. You must declare below any convictions, cautions, summons or fixed penalty notices. You must also
declare all spent convictions.
Do you have any of the above:
YES / NO
If yes please describe below
_______________________________________________________________________________________
______________________________________________________________________________________
In accordance with the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975, and the Rehabilitation of
Offenders (Northern Ireland) Order 1978 (Exceptions) Order 1979, spent convictions may be taken into
account where National security is concerned.
2. You must also declare any investigations (both in the UK and abroad) either by police, military and or other
statutory prosecuting authorities (e.g. Inland Revenue, Immigration) including those pending.
YES / NO
If yes please describe below (Please continue on a separate sheet if necessary)
_______________________________________________________________________________________
_______________________________________________________________________________________
3. Have you ever been involved in any actions that could be described as Political / Religious / Racial /
Environmental / Disruptive.
YES / NO
If yes please describe below (Please continue on a separate sheet if necessary)
_______________________________________________________________________________________
_______________________________________________________________________________________
4. Do you associate with any person(s) (inc family members) who you know or have reason to believe has
criminal convictions, or is engaged in criminal activities? Are you aware of any other circumstances or
characteristics, which may impact on vetting clearance?
YES* / NO *If yes please describe below:
(Please continue on a separate sheet if necessary)
_________________________________________________________________________________________________
________________________________________________________________________________________________
DECLARATION
 I consent to the information provided on this form being used by the vetting unit for the purposes of vetting.

I declare that the information I have given is true and complete to the best of my knowledge and belief.

I undertake to notify any material changes in the information I have given.

I consent to a financial check being carried out.

I understand that any false statement or deliberate omission I have given in this questionnaire may
disqualify me for the position applied for and may make me liable to discipline action.

I understand it is my responsibility to inform those named on the form that their details have been provided
for the purpose of my vetting application.
Signed: _________________________________________ Date _________________________
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