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How do I fill this out?
Filling out this form is straightforward. Ensure you have all necessary personal information ready. Follow the instructions provided and answer each question accurately.
How to fill out the Basic Criminal History and Admission Statement?
1
Gather your identification and any necessary documents.
2
Fill in personal details such as your name and date of birth.
3
Answer all questions honestly, especially regarding past legal issues.
4
Sign and date the form at the bottom.
5
Submit the completed form to the designated authority.
Who needs the Basic Criminal History and Admission Statement?
1
Prospective employees of DoD Child Care Services require this form to verify their background.
2
Volunteers working with children in DoD programs need to establish their suitability.
3
Currently employed staff must complete the form annually for ongoing compliance.
4
DoD contractors must fill out this form to assess fitness for child care roles.
5
Family Child Care providers need this documentation to certify their household's eligibility.
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Edit this PDF through PrintFriendly by easily selecting any field to modify. You can adjust text entries, ensuring all information is current. Once your edits are complete, download the updated document for your records.
1
Upload your PDF document to PrintFriendly.
2
Select the text or fields you want to edit.
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Make necessary changes directly in the document.
4
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5
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What are the instructions for submitting this form?
Submit the completed form to the Department of Defense via email at informationcollections@mail.mil. Alternatively, you may fax the document to the designated number for your specific program. Ensure you keep a copy of the submitted form for your records.
What are the important dates for this form in 2024 and 2025?
This form is valid as of December 2021. OMB approval expires on October 31, 2024, meaning updates might be needed after this date. Be aware of potential changes in regulations for 2025.
What is the purpose of this form?
The primary purpose of this form is to gather vital criminal history information from individuals seeking to work with children under the Department of Defense. It ensures compliance with stringent background check requirements to maintain a safe environment for children. By collecting this data, the DoD aims to assess the suitability and fitness of personnel associated with child care services.
Tell me about this form and its components and fields line-by-line.
- 1. Name: The complete name of the applicant, including last, first, and middle name.
- 2. Other Names Used: Any additional names the applicant has used, including maiden names.
- 3. Date of Birth: The applicant’s date of birth in YYYYMMDD format.
- 4. Installation/Program Name: The specific DoD installation or program for which the applicant is applying.
- 5. Date of Hire: The anticipated or actual date of hire, to be filled by HR.
- 6. Criminal History Disclosure: Questions pertaining to past legal issues to assess suitability.
- 7. Signature: A space for the applicant to sign and date the form.
- 8. Annual Certifications: Confirmation of criminal history status updates annually.
What happens if I fail to submit this form?
Failure to submit this form may result in disqualification from the DoD Child Care Services Programs. Additionally, it could affect employment status and suitability for the related roles. It is critical to ensure timely and complete submission to avoid any negative implications.
- Unfavorable Adjudication: Not submitting or providing incomplete information may lead to a negative evaluation.
- Ineligibility for Employment: Failure to comply with the form submission can result in ineligibility for desired positions.
- Legal Consequences: Misrepresentation or failure to disclose required information can result in legal implications.
How do I know when to use this form?
- 1. Initial Employment Applications: To verify the background of new applicants seeking positions.
- 2. Annual Re-certification: For current employees to confirm their ongoing suitability.
- 3. Volunteer Applications: For individuals volunteering in child-related programs.
- 4. Contractor Engagement: Required for contractors involved with DoD child care services.
- 5. Records Updates: To report any changes in criminal history or legal status.
Frequently Asked Question
What is the purpose of this form?
This form is used to collect criminal history for individuals working with children in DoD programs.
How can I access the editable version?
Upload the file to PrintFriendly to access the editor.
What information do I need to complete this form?
You will need personal identification details and any relevant legal history.
Can I save the form after editing?
Yes, once edited, you can download the form in a PDF format.
What should I do if I made an error?
Simply re-upload the document and edit the required fields.
Is there a deadline for submission?
Check with your program's specific requirements for submission timelines.
Who reviews these forms?
The forms are reviewed by designated HR or compliance officials.
Can I share this form electronically?
Absolutely, you can share it via PrintFriendly's sharing capabilities.
What if I have questions while filling it out?
Refer to the guidelines provided within the form for assistance.
Is this form mandatory?
Yes, it is required for all participants in DoD Child Care Services.
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