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23456Page 1 of 7By virtue of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975, the provision of the Rehabilitation ofOffenders Act 1974 does not apply to questions on this form relating to previous convictions. The applicant is,therefore, not entitled to withhold information about a previous conviction, traffic offence, appearance before aCourts Martial or juvenile caution, on the grounds that it is, for other purposes, spent under that Act.Has the applicant ever been convicted, cautioned, arrested, charged, appeared before a Courts Martial or receivedany Bind-Over Orders, Traffic Offences or Informal Actions? Does the applicant have any impending prosecutionsor any outstanding matters with any police force? If yes please give particulars in the box below.NB. Disclosures do not automatically bar the applicant from appointment, each case is considered individually.However, failure to provide information that comes to light at a later date will result in disciplinary action.If appointed the applicant will be required to provide similar information for Counter Terrorist checks.(19/11/2008)

INSTRUCTIONS TO APPLICANTS

The Chief Constable reserves the right to reject any application without giving reasons.1

RETURN FORM TO

Name E-mail

APPLICANT DECLARATION

I hereby declare that all the details I have given on this form are true to the best of my knowledge and belief.

Applicant's signature DateNorthamptonshire Police will access information held on the Police National Computer, National and LocalIntelligence Systems, Financial databases and Residency databases to confirm an applicant's suitability foremployment.

BASIC DETAILS OF APPLICANT

VETTING FORM

Applicant surname (present)Applicant forename(s) (present)Is the applicant currently employed by Northamptonshire Police?Name of post applied forDepartment where post is based

RESTRICTED (when completed)

***Failure to declare any of the above will result in your application being rejected******Question 3 is mandatory - DO NOT LEAVE BLANK***

APPLICANT'S FINANCIAL POSITION

Full details (including dates)YES NO

Unless otherwise stated, these questions should be completed in respect of

the last six years

.Page 2 of 7(19/11/2008)

VETTING FORM

Has the applicant had a loanarrangement terminated by a bank / building society / finance house / other?Has the applicant had a credit / charge / store card withdrawn?Is the applicant in arrears with anyexisting loan / mortgage / hire purchaseagreement?Has the applicant ever been registeredas bankrupt?If the applicant has ever been registeredas bankrupt, have the bankruptcy debtsbeen discharged?

Has the applicant had any Court actiontaken against them for any debt?Has the applicant been party to avoluntary agreement registered with theCounty Court?Has a County Court / TribunalJudgement been made against theapplicant?If the applicant has had a County Court / Tribunal Judgement made against them,has this now been cleared?

Has the applicant had repossessionproceedings commenced against them?Has the applicant consolidated all theirdebts with one lender?

RESTRICTED (when completed)

* If applicable, please provide a Certificate of Satisfaction as it is needed before the application can be processed.

Page 3 of 7(19/11/2008)

VETTING FORM

DETAILS OF APPLICANT

Applicant surname (now)Other surnames used (aliases)Applicant forename(s) (now)Applicant genderApplicant nationality (now)Applicant date of birthApplicant current addressApplicant current postcodeApplicant telephone number(previous)(previous)(previous)Applicant place of birthResided in current address since (date)

RESTRICTED (when completed)

Applicant's previous addresses in the UK for the last 5 years

(INCLUDE DATES OF RESIDENCE FOR ALL PREVIOUS ADDRESSES)

If applicant has lived outside of the UK for 3 months or more in the last 3 years, give addresses and dates of residence

(INCLUDE DATES OF RESIDENCE FOR ALL PREVIOUS ADDRESSES)