*KEEP THIS PAGE FOR YOUR RECORDS*
POSITION TITLE AND NUMBER:
REVENUE CLERK – 103
DATE APPLICATION FILED:
MARSHALL COUNTY PERSONNEL BOARD
APPLICATION FORM
APPLICANT INFORMATION
PLEASE CAREFULLY READ THE FOLLOWING BEFORE COMPLETING YOUR APPLICATION
A SEPARATE APPLICATION FORM IS REQUIRED FOR EACH POSITION TITLE
Completing the Application
You may print the application form and complete it manually or type information directly into
the shaded areas. To complete the form online, you must use the tab key to move from cell to
cell. If printing out the application form to complete it manually, the shaded areas will not
print out. Once completed, the application must be signed and mailed or hand delivered to
the Personnel Office address below.
Your application for employment with Marshall County is our only source of information about you. All
applications, including those for promotional and transfer positions, MUST be completed IN FULL. All
questions must be answered so applications can be given equitable consideration. RESUMES ARE
ACCEPTED. A notation "See Resume/See Attached" will not be used for evaluation purposes. If a question
does not apply indicate "N/A" for non-applicable. Failure to record both month and year when requested will
result in minimum credit. IF YOU NEED ADDITIONAL SPACE ON ANY SECTION OF THE APPLICATION
YOU MAY ATTACH ADDITIONAL SHEETS. PLEASE INDICATE ON EACH SHEET THE SECTION OF THE
APPLICATION THE INFORMATION PERTAINS TO AND BE SURE YOU USE THE SAME FORMAT AS
THAT SECTION.
If any position requires a certificate, license, etc. then these documents must be submitted with the application
or by the closing date of the position announcement. Failure to provide this information will result in the
application not being referred to the hiring office/department. The Personnel Board will not make copies of any
required documents. The applicant must provide one copy of all documents he or she wants to submit with the
application.
A completed official application must be received by the established closing date as stated on the
announcement. An announcement with an "indefinite" closing date will remain open for a minimum time as
specified on the announcement, but after that time may be closed without notice. Any announcement may be
extended at any particular time during the advertising period at the discretion of the Personnel Administrator.
Applications and materials relevant to the application process will NOT BE ACCEPTED via FAX. Photocopies
of applications are accepted if they are legible.
YOU MUST SIGN AND DATE THE APPLICATION FORM. APPLICATIONS THAT ARE NOT COMPLETED
IN FULL AND SIGNED WILL NOT BE CONSIDERED.
Job Requirements
Please note the education, experience, and other special requirements listed in the announcement for the jobs
that interest you. These are minimum standards all applicants must meet in order to be considered for
employment.
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Employment Policy
It is our policy that employment decisions are made on the basis of merit and fitness for the position.
MARSHALL COUNTY IS AN EQUAL OPPORTUNITY EMPLOYER. All applicants are required to provide
proof of identity and authorization of employability at the time of appointment. All offers of employment may be
contingent upon successful completion of a post offer drug screen and physical examination.
Hiring Procedure
1.
Every application received by the established closing date is reviewed for minimum qualifications and
competitiveness by the Marshall County Personnel Board. Should you meet the requirements for the
position, your name will be placed on a list of eligible candidates. Your name will remain on this eligible list
for six (6) months or until the list expires, whichever occurs first.
2.
When a county department notifies the Personnel Board of a desire to fill a vacancy for a position the
Board certifies to the department the top three names on the appropriate eligible list.
3.
Hiring departments hold interviews with applicants who are referred by the Personnel Board. The hiring
department will notify persons selected for interviews.
4.
After the interviews and other selection procedures, the hiring department makes a selection and returns
all applications to the Personnel Board. Those candidates not selected will remain on the eligible list and
will be considered for future vacancies.
Additional Information
You may obtain information on Marshall County Personnel Board job announcements by visiting the county
web site at http://www.marshallco.org.
PREFERENCE: Qualified Marshall County classified service employees will be afforded preference when
establishing eligible lists.
YOUR INTEREST IN COUNTY EMPLOYMENT IS APPRECIATED!!!
Should you have a change of address or phone number after filing an application let us know!
Marshall County Personnel Board
Marshall County Courthouse, Room A342
424 Blount Avenue
Guntersville, Alabama 35976
(256) 571 – 7720
Office hours: 8:00 a.m. – 12:00 p.m. and 1:00 p.m. - 4:30 p.m., Monday through Friday
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APPLICATION FOR EMPLOYMENT
Marshall County, Alabama
Marshall County Personnel Board
Room A342, Courthouse
Guntersville, AL 35976
MARSHALL COUNTY IS AN EQUAL OPPORTUNITY EMPLOYER. THOSE APPLICANTS REQUIRING ACCOMMODATION TO THE
APPLICATION AND/OR INTERVIEW PROCESS SHOULD CONTACT THE MARSHALL COUNTY PERSONNEL BOARD.
ENTER SOCIAL SECURITY NUMBER BELOW.
DATE OF APPLICATION
IMPORTANT: Please carefully read the applicant information section before completing this application. Please type or print using black or blue ink.
NOTE: This application may be used to fill both classified and unclassified positions in county government; however, use of this application in no way
confers classified service status on any position that may be exempt from the classified service.
POSITION FOR WHICH YOU ARE APPLYING (one per application)
JOB CODE:
Revenue Clerk
103
Full Name
Last
First
Middle
Address
House or Apartment Number
Street
City
Telephone Number:
State Country
Home (
)
Work (
Area Code
Zip
)
May we contact you at work?
Yes
No
Area Code
PERSONAL INFORMATION
If employment is offered, can you provide verification of your legal right to work in the United States?
Are you over 18 years of age?
Yes
Yes
No
No (If not, employment is subject to verification that you are of minimum legal age and are able to supply
any required work permit.)
Are you able to meet the attendance requirements of the position?
Are you willing to work overtime and holidays if required?
Yes
Yes
No
No
Date available for work.
Type of employment desired:
Full-time
Part-time
Temporary
Valid driver’s license number (if job related)
Is this license a Commercial Driver’s License?
Have you previously worked for Marshall County?
State
Yes
Yes
No
If yes, what class?
No
If yes, give dates and the position(s) you held.
REFERENCES (List three reliable persons, not relatives or employers, who know you well enough to give information about you)
NAME
ADDRESS AND PHONE NUMBER
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EDUCATION
CHECK THE HIGHEST GRADE OF SCHOOL COMPLETED.
High School Diploma or GED?
Yes
No
1
2
3
4
5
6
7
8
9
10
11
12
College
1
2
3
4
PROVIDE INFORMATION ON ALL SCHOOLS ATTENDED. SPECIFY UNDERGRADUATE OR GRADUATE WORK.
COLLEGE
VOCATIONAL / BUSINESS
Name and Address of School
Credit
Hours
Sem. Qtr.
Did You
Graduate?
Yes No
Type of Degree and Dates Attended
Major
PROFESSIONAL LICENSE OR CERTIFICATE
License/Certificate Issued By
Field/Trade/Specialization
License/ Certificate No.
Issue Date
Expiration
Date
Fully describe any other special qualifications and skills possessed (i.e. skill with machines, computer software, foreign language) which relate to the
job for which you are applying. Explain extent of experience and how acquired. Attach additional sheets if necessary
Have you ever been involuntarily terminated, discharged, forced or asked to resign from any job?
Yes
No
If you answered Yes to the above question, attach an explanation on a separate sheet noting any mitigating or extenuating circumstances.
Have you even been convicted of a misdemeanor or felony crime?
Yes
No
If you answered Yes to the above question, list in the space below all prior misdemeanor and felony convictions and any extenuating or
mitigating circumstances regarding such convictions. If necessary, you may use a separate sheet or sheets and attach to application.
NOTE: A CONVICTION RECORD DOES NOT AUTOMATICALLY MEAN THAT APPLICANTS CANNOT BE APPOINTED, EXCEPT THAT A
FELONY CONVICTION WILL BAR EMPLOYMENT IN A LAW ENFORCEMENT JOB. OTHER CONVICTIONS WILL BE WEIGHED
RELATIVE TO THE POSITION BEING SOUGHT
FAILURE TO DISCLOSE A CONVICTION MAY BE CONSIDERED AS GROUNDS FOR DISQUALIFICATION. FOR THESE REASONS,
APPLICANTS SHOULD BE CAREFUL TO DISCLOSE ALL CRIMINAL CONVICTIONS.
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WORK HISTORY
THIS SECTION MUST BE COMPLETED REGARDLESS OF WHETHER OR NOT A RESUME’ IS ATTACHED.
Begin with your PRESENT or most recent employment. List in REVERSE ORDER periods of employment. Each time you changed jobs or
your title changed should be listed as a separate period. Describe in detail your duties. Include military and/or voluntary experience in the
same format listing the word “Volunteer” or “Unpaid.” (Attach additional sheets if needed)
1. Current or Last Employer
Your Official Job Title
Address
Type of Business
FROM
Month
TO
Year
Month
Year
Total
Yrs./Mos.
Number of Hours
Per Week
Beginning Salary
$
Per
Number/Title of Employees You Supervised On a Continuing Basis
Equipment You Operated
Name, Title and Telephone Number of Supervisor
Reason for Leaving
Ending Salary
$
Per
May we contact your
Employer?
Yes
No
Describe Your Duties in Detail
2. Employer
Your Official Job Title
Address
Type of Business
FROM
Month
TO
Year
Month
Year
Total
Yrs./Mos.
Number of Hours
Per Week
Beginning Salary
$
Per
Number/Title of Employees You Supervised On a Continuing Basis
Equipment You Operated
Name, Title and Telephone Number of Supervisor
Reason for Leaving
Ending Salary
$
Per
May we contact your
Employer?
Yes
No
Describe Your Duties in Detail
3. Employer
Your Official Job Title
Address
Type of Business
FROM
Month
TO
Year
Month
Year
Total
Yrs./Mos.
Number of Hours
Per Week
Beginning Salary
$
Per
Number/Title of Employees You Supervised On a Continuing Basis
Equipment You Operated
Name, Title and Telephone Number of Supervisor
Reason for Leaving
Describe Your Duties in Detail
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Ending Salary
$
Per
May we contact your
Employer?
Yes
No
4. Employer
Your Official Job Title
Address
Type of Business
FROM
Month
TO
Year
Month
Year
Total
Yrs./Mos.
Number of Hours
Per Week
Beginning Salary
$
Per
Number/Title of Employees You Supervised On a Continuing Basis
Equipment You Operated
Name, Title and Telephone Number of Supervisor
Reason for Leaving
Ending Salary
$
Per
May we contact your
Employer?
Yes
No
Describe Your Duties in Detail
Please explain any gaps in employment:
COMPLETE THIS SECTION IF YOU ARE CLAIMING VETERAN’S PREFERENCE
If you claim Veteran’s Preference, check the type below. Attach copies (which will not be returned) of the required documents to your
application to support your claim. YOU WILL NOT RECEIVE VETERAN’S PREFERENCE POINTS UNLESS YOU FURNISH REQUIRED
COPIES OF THE APPROPRIATE DOCUMENTS.
Veteran (5 points) – Requires DD214 or document showing dates of service and type of discharge.
Disabled Veteran (10 points) – Requires DD214 or other document as above and letter of disability from V. A. dated within last 6 months.
Deceased Veteran’s spouse (10 points) – Requires DD214 or other document as above and marriage and death certificates. Cannot be
claimed if spouse remarries.
Disabled Veteran’s spouse (10 points) – Requires DD214 or other document as above and V. A. letter of disability dated within last 6
months. Cannot be claimed unless still married to disabled veteran.
Permanently Disabled Veteran (10 points) – Requires DD214 or other document as above and V. A. letter indicating permanent disability.
Use this section to include any further information you wish us to consider:
APPLICANT’S STATEMENT (PLEASE READ CAREFULLY AND ASK ANY QUESTIONS BEFORE SIGNING)
I certify the information given by me in this application (and attachments) and all other information furnished in the application process is true and
complete to the best of my knowledge. I understand any false information, misrepresentation, or concealment of fact is sufficient grounds for my
application to be rejected or, if employed, my employment to be terminated.
I authorize the county to conduct a background investigation pertaining to my suitability for employment, which may include a criminal history check. I
hereby authorize the release of information about my ability and fitness for employment with Marshall County by law enforcement agencies, employers,
schools, and other individuals and organizations to authorized employees of Marshall County. I hereby release the aforementioned persons,
corporations, agencies, associations and their employees, agents, and representatives from any liability for any claim or damage, which may result from
compliance with this authorization.
I understand I may be required to submit to a drug screening as a condition of employment and refusal to submit to drug testing during the course of my
employment may result in disciplinary action, up to and including discharge. I further understand that as a condition of employment I may be required to
successfully pass a post offer physical examination.
Applicant’s Signature
Date
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MARSHALL COUNTY PERSONNEL BOARD
SUPPLEMENTAL DATA SHEET
REVENUE CLERK – JOB CODE 103
NOTICE: COMPLETION OF THIS DOCUMENT IS MANDATORY
Full Name
First
Middle
Last
The examination for Revenue Clerk, Code 103, is in the form of a qualifying training and experience evaluation that will be
performed by the Personnel Board. Your score and rank will depend on the information you provide about your
qualifications on your application and in this questionnaire. Please give specific, accurate, and complete information on
this “Supplemental Questionnaire” and on the “Employment Application” regarding your experience in areas related to this
job. If you need more space, you may obtain additional pages from the Personnel Office, or you may submit any
document you have which provides the information about your qualifications you wish to give to the Personnel Board.
After the eligible list has been established no adjustment to your score can be made for information you have failed
to provide. All information is subject to verification.
I certify that all answers to the attached questions are true and correct and I understand that any misstatement of material fact contained on
this questionnaire may cause forfeiture upon my part of all rights to any employment subject to the jurisdiction of the Personnel Board of
Marshall County, Alabama.
APPLICANT’S SIGNATURE
DATE
1. List the typing, bookkeeping/accounting, and/or computer courses you have completed and passed at the high school
or college (including business college) level. Indicate whether each course was completed at the high school or
college level.
If you have ever been tested for your typing speed and accuracy please provide, if you have a record, your score and
indicate where and when you were tested.
Please check any of the following Microsoft software of which you have knowledge and some skill in use. Also
indicate your estimate of your knowledge and skill level with each product. You may be required to demonstrate your
knowledge and skill level.
Windows
Skill Level:
Low
Moderate
High
Skill Level:
Skill Level:
Skill Level:
Skill Level:
Skill Level:
Low
Low
Low
Low
Low
Moderate
Moderate
Moderate
Moderate
Moderate
High
High
High
High
High
What Version of Windows?
Word
Excel
Power Point
Outlook
Access
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2. Do you have experience using a multi-line phone system?
Yes
No
Please indicate below the employers listed in the “Work History” section of the application where you gained this
experience.
3. Please indicate below the office equipment you have experience in using
computers
fax machines
copiers
other(please specify)
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EQUAL OPPORTUNITY/AFFIRMATIVE ACTION SURVEY
COMPLETION OF THIS FORM IS VOLUNTARY
Federal and state laws prohibit discrimination because of race, religion, color, age, sex, national origin, disability, or any other legally
protected status.
In an effort to comply with requirements regarding government record keeping, reporting, and other legal obligations, we ask that you
complete this survey. Your cooperation is appreciated.
Please be advised that this survey is not a part of your official application for employment. It is considered confidential information that
will not be used in any hiring decision.
POSITION FOR WHICH YOU ARE APPLYING (one per application)
REVENUE CLERK
JOB CODE:
103
Full Name
First
Male
Middle
Last
Female
Please check one of the boxes below that corresponds with your ethnic origin
White
Black
Hispanic
Asian/Pacific Islander
American Indian/Alaskan Native
REFERRAL SOURCE – HOW DID YOU HEAR ABOUT US?
Marshall County Employee
Alabama Employment Service
Marshall County Web Site
Job Announcement—Location:
Walk-in
Newspaper Ad—Source:
Other:
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