Signature of Applicant Date , Applicant Interviewee/Witness Date Interview Date RECORDS INQUIRY The information you disclose on this page will be verified through the Justice Information Management Systems (JIMS) and the National Crime Information Center (NCIC). Misleading statements, falsifications or omissions could disqualify your application. Date: Position Applied for: Personal Information (type or print clearly) Name: Last First Middle Race: Gender: Date of M F Driver License #: State Issued: Social Security #: Other: Criminal History Request Two U.S. states are non-participants in the (NCIC). Check the Maine Vermont corresponding box if you resided in either of these states: BELOW FOR OFFICE USE ONLY Harris County Data Source: JIMS through internet, or Operator: Warrants: No. Type operator's name. Yes. Warrant #: Charge: Agency: Phone #:
Signature of Applicant Date Interviewee/Witness Date RECORDS INQUIRY , Applicant Interview Date The information you disclose on this page will be verified through the Justice Information Management Systems (JIMS) and the National Crime Information Center (NCIC). Misleading statements, falsifications or omissions could disqualify your application. Date: Position Applied for: Personal Information (type or print clearly) Name: Last First Middle Race: Gender: M F Date of Driver License #: State Issued: Social Security #: Other: Criminal History Request Maine Vermont Two U.S. states are non-participants in the (NCIC). Check the corresponding box if you resided in either of these states: BELOW FOR OFFICE USE ONLY Harris County Data Source: JIMS through internet, or Operator: Warrants: No. Type operator's name. Yes. Warrant #: Charge: Agency: Phone #:
ApplicantInterview.docx