Scribd Logo
Upload

Welcome to Scribd!

  • Omar Mateen Personnel File 6

    Uploaded by

    WGRZ-TV
    5K views23 pages
    Omar Mateen's Personnel File

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    Omar Mateen's Personnel File

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    5K views23 pages

    Omar Mateen Personnel File 6

    Uploaded by

    WGRZ-TV
    Omar Mateen's Personnel File

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 23
    Affidavit of Separation: CIST I FDOLE Florida Department of Low Enforcement Please type or print in black or blue ink and use capital and small letters for names, tiles, and addresses Social Securty Number Name: Mateen, Omar S ‘Agency name: Dc, Region 4 Agency OR: FLOD6OSSC Date employed: 10/27/08. Separation date: 430107, n#61 AFFIDAVIT OF SEPARATION Incorporated by Reference in Rule 118-27.002(3)(a)15, F.A.C. Page | of 1 ‘Employment Type Law Enforcement I~ Correctional 7 Correctional Probation I Concurrent 7 Special Eected of Appointed I Fulltime Part tne [Auxiliary 7 SEPARATION REASONS "ADMINISTRATIVE - ROUTINE Voluntary separation nat invving misconduct Transfer within ageney. No break in Retired. Not involving misconduct T Deceased Budgetary Constraints, Local and Fecera gate rot erewed TT Extended leave of absence or Suspention Tore Pero Tis insane terinaton not invoving econ T Special elected or appointed Position: Anticipated ve "ADMINISTRATIVE - NON-ROUTINE ‘UNFAVORABLE - MISCONDUCT T Falure to compete basic rerut taining | [Voluntary separation or retirement while betng investigates for vation of agency Titre to pass the State Ofcar Poly not involving a moral character \Centiestion Examination violation defined in Rule 118-27 0011, FAC, F Terminated for violation of agency policy (Not invoWing @ moral character voialon efined In Rule 118-27 0011, FAC) ADMINISTRATIVE - SUBSTANDARD PERFORMANCE Fiture to satstactorly complete agency fel ring rogram (ranng poromance T Faire to pertorm assigned tasks satisfactory Form CJSTC-61A must be completed and ‘submitted with form CASTC-61 for ether of the following: F Voluntary separation or retirement while being investigated for vicaton of Section 943.19(4), F'S., oF violation of moral character standards defined in Rule 118- 270011, FAC. © Terminated for violation of Section 943.13(4), FS, or violation of moral ‘Sharacer standards as defined by Rule 11B- 27.0011, FAC, OTHER - EXAMPLE. Excessive absenteeism; falure to report for duty and sleeping on duty, ete NOTICE: Section 949.129(2), FS. requires the execution ofan Affidavit of Sep separation. Ifthe offceis separated, wneth ton bythe empleying agency ina case of oficar voluntary or involuntary, or failure to comply with provisions of Section 843.13, FS. you a Fequire to so specify when completing the Affdavit of Separation Supplement form CISTC-S1A. WARNING: lntentonal false execuvon of this Affidavit of Separation constfutes a misdemeanor of the second degree, In the State of Florisa, County of before me this day personaly appeared. who being duly swom, deposes and says: | fereby cerly Thatto the bes! of my knowledge and beset, th reason Tr The Separation aFThe officer named ‘on tis affavi, and the detlod facts and reasons reported onthe Form 61A (applicable) are true and correct ‘Agency administrators signature STATE OF FLORIDA, COUNTY OF (monthiyear) by (type ofdentiication) as dentifcation and who did (sk not take an oath, Notary's name. Notary’ tle/rank Effective 10/16/1997 http:/Awww.fale.state.fl.us/ATMS2/Forms/CJSTC61.asp?person_nbt Dato signed ‘Agency administrators name and title ‘The foregoing instrument was acknowledged before me tis. wh is personally known to me or who has produces, day of__ Notary's signature Seriatnumber Revised 27/2002 169974&ssn=090-78... 5/16/2007 FDLE Flotida Department of aw Enforcement u incorporated by Reference in Rule OFFICER CERTIFICATION APPLICATION ‘1 27 Please type o pintn lack or blue ink and use capital and small eters to wte names. 1. Soca Secuty number Opn 2 mime a0 ae Hf 6 Gana _f r “The applicant’ name shal match the appleane birth cetfest or proof ciizensip. Supporteg docurentaion ef name change must be manned Ai Date signature 8. The following are requirements for certification as an officer: simu age of 19 choot Graduate or Equivalent fackground Investigation form CJSTC-77 of of miltary discharge, if aplicable Fingerprint Response on fie and Fingerprint Notification form CJSTC-62, Uereby atest Seton 5 3410 F ety apes pan re, Rathey seinistators signature 12. STATE OF FLORIDA, COUNTY OF 13. By 14, Type of dentiication: Notary’ Signature who Is personally known povcy ott nunter _ LID AOAST Agency name: 4 a Graton tmpioyertdne:___ /0/2 7/26 centeaion yp Law Enforcement Law Enforcement Auxilary rectional Cortctionsl Auxiliary Correctional Probation clan's Assessment frm CJSTC75, of equivalent ‘Drug Screening Results idavit of Applicant Form CuSTC-88 Completion of Basic Recruit Training -Aczoplabe Score on Officer Certifcation Examination Tumentation supporting egal name change, if applicable | have collected, verfed, and have on le documentation open for Commision inspection thal the applicant has met the provisions a 1 lifafee Ds The forging instrument was acknowledged before me this date or who has produced identiiation Wolary Seal Print, type, or etap Cammiscloned Name of Notary [NOTE: This form should ONLY be submited after he above documentation son fil, including the processed Fingerprint Response ‘CASTE USE ONLY FOLE Field Specalsts Name Review Date Erective 12171988 Original ~ FOLE Copy-Employing Agency Revised 272002 Registration Affidavit of Comr"ance: CIST Form #60 Page | of 1 FDLE REGISTRATION OF EMPLOYMENT CUSTC pari napanwnt st AFFIDAVIT OF COMPLIANCE 60 Loreal Incorporated by Reference in Rule 11B-27.002(2), F.A.C. Please type or print in black or blue Ink and use capital and small letters for names, tities, and addresses 1. Social oe | 10. EMPLOYMENT TYPE: Full-Time , Correctional 2 NAME: Mateen, Omar 11, Hofer completed auxiiary training, does agency have proof of quired high ably training on fie? 2. ATE OF oR ves one: 7 no 4. ETHNIC GROUP OR RACE: White 12. |s this offcer employed under a Temporary Employment ‘Authorization? 5. SEX: Malo. Mves TF Wo 6 EDUCATION Note: Ifyes, complete the Temporary Employment Aetatdtan ore sane 0 Note: To recave eucatona slay incentv, compete the her Eqvectn pen Porn coe teS 1%, ten er ies rst ritngt Tves MF No 7. AGENCY oRt-FLonEossc Not: ye, complet the Eauvaleney of Tang fm CaS 8. AGENCY NAME: be Region 4 Sond CSS Ten oa ans or Fosnta Oca oo Taminon te EMPLOYMENT DATE: oz706 14. Does you agony rave ermal fcas frgerset \naaby catty that nav colectd, verted and ame rocessng ar ich maintaining on file evidence that the applicant has met. T Yes Date: No Be pronto of Sector sts arena ee, or any re tdopted pursuant teas ly ance Seed Pes ees easy aaa tatthisatiaartsonstues an ciel sasnentuner ‘Nol: ye, late indcale he at tat You rca te pw of eston 6S ssbets rhea te bara nasek Sa Sees Me CIES SCR in: Goan yuursgucy homo ive vr cofncted ‘this afidavit constitutes a misdemeanor of the second, Substanco screening results as required in Rule 118-27 002257 Fives 1 No 17 -D Date signed ‘Agency Administrators THe 19. STATE gF[LEYDA. coUNTY OF. ao yor! ‘The foregoing instrument was acknowledged before me this date Ll wo Otro wa) cx unahil ee Susatsbdass ‘Type of dentition: z Nota’ Signature bluana (Upon witnessingVour agency administrator or designee signing this Print, ype, oF stamp Commissioned Name of affidavit, the notary public shall complete the notary block) Notary Rotary Se Effective 11/1/1995 Revicod2/72002 http://www. fille. state.fl.us/ATMS2/Forms/CJSTC60.asp?person_nbr=269974&ssn=090-78... 12/1/2006 HoT: 6-141 er 11-16-2008 : pocumentag™A 012¢ Dep CERTIFICATE OF BIRTH REGISTRATION Below is an exact copy of a certificate of Birth registered for your child. It is sent without charge. If the certifieate contains any errors return this copy with the correct information tothe Bureau of Vital Records, 125 Worth Street, New York, N.Y. 10013. You will be advised how to have the record correcied. It is important to do this at once. The reproduction or alteration of this transcript is prohibited by Section 3.21 of the New York City Health Code. Notice In issuing this anscip: ofthe recor, the Deparmant of Heath of te Cty of Now York doesnot cet to te truth ‘of te sinloments mae thergun as no inuy geo Ths late as bee prow! by . Ousond VG Smee YU aa nem Aion MAYOR COMMISSIONER OF HEALTH “cry REGISTRAR Hl _ MBERTIFICATE OF BIRTH aM 3 ag PM "86 oremo | Omar Mir Seddvque Wc pas a a 5 = — pens Esland Se wish Medical Cont hi Shahla Anwar se Afghan sta \ lushing Mer Mohamad Seddigue i [Ba NAME OF ATTENDANT AT DELIVERY | BUREAU OF VITAL RECORDS | wnetlrs Shabla Sedds eee | se I-09 1.53 St SE RT ae ee? goon 2 UBT 7-2006 THU 03:10 PM MCSD FAX NO. 772-719 1236 P.O Reands Departne 500 East Ona Bi Star, FL. 34994 772-218-1200 x 3042 FAX: 7722191235 Fax m= Tiny war rs mm Aizen WON vee DE IG/-SB__ row (Al ADIGELUL) wre LA VGY-BIA Desf rate F/I PO pee PYAR pp TEED oe CDurgent Pf ForReview [1 Please Comment CiPlaase Reply 1 Please Racycie — cennte. TEARSERIPT ATACHD Nateen Walton Reconis Mangement Lisson Officer FDLE EMPLOYMENT BACKGROUND Florida Deparment of INVESTIGATIVE REPORT Incorporated by Reference in Rule 118-27.002(3)(a)2, F.AC. Ficase ype ov nn Back or Bu Hk and ie capal and sal pers ornamea Wey and SUS 1. Oftcers name Maxey Ona ft ast Mi 2. Social Security Number: (Option) 3. Agency oni FL_(YUaAS ST 4. Agency Name: J 4 OECD AS 5. Disciplines: C1 Law Enforcement Cl Correctional rotation C2 RaitoadPoice C-€Gestonal C0 Cereurent 5._ RESULTS _ "ANDATORY CHECKS SATISFACTORY Neighborhood! 2 Previous Employment (se las box) FCIC Record NCIC Recor Local Law Enforcement | itary History Controlled Subs {or information on the applicant's previous crminal Justice employments or Commission action RECOMMENDED NOT UTILIZED sob Related Psychological Examination o a a Polygraph Examination o o ao APPLICANT ADMITS TO: [1 Having previously committed an ac, which constitutes a felony or misdemeanor oven i detected, not arrested or not prosecuted inclusin, but nt linited to, thet, possession of lege drugs, aud, ete eserte: $/9/0/ Di phen of Eclecnberal lath, Bectlers — Mel vofh 8. CURRENT AND RECENT ILLEGAL USE OF CONTROLLED SUBSTANCE (indicate type and date last used) DF Mariana Di Cocaine_ D7 opistes 1 Designer Drugs 1 otter _— Be Z 38, admitted acts, and other drug use below 9. INVESTIGATIVE FINDWGS. Please desu any unsistactoy fn Zee = Te eons Rule 118-27.0011, FAC, requires an applicant's moral characier fo be carefl Inesinten excises ath pcan ee a gat oy of tr avs cont te Con does nat hie the applicant, and that documentation ofa backgrou I ivesiatopieon fl, 10, Signture and Atestment of Background inves ou aoe al ae fod. {rey rity based onthe shove fairs contre by this agency thatthe appicat is of good moral characters regied by Section 943.13(7), FS Bae Ly (ake Sighed) wu) +f, Signaturd DER wAVRG Agency Administrator or Designee (Requled) Effective 1111995 Original ~Agency Cony FOLE Revised27/2002 This form must be attached to the Registration of Employment, Affidavit of Compliance form CJSTC-60 FDLE AFFIDAVIT OF APPLICANT orporated by Reference in Rule 118-27.002(1)(, F.A.C. and addresses Please ype or print black or buo ink ane usa eaptl and milters or names, sec ety hunt: repens apirone Nice OM S aaa Fist i “Dept. of Covechors ¢f ae Use theo ovary your complica wh he ampaymen regu of ection 43.13, Flyers tlt gal pee 2 mercer crasonerenacioa proteome Iahl srg mth long ovens of Seen S018 FS Employing agency contondra to ris fund pity ofa felony oof @ misdemeanor + Bo atloast 19 years of age + Beacizenofthe Unie Stats Invohing parry or a fae sltoment shal not bo egible for 1+ Beshigh schoo graduate or equvaln, fenpoyment or appinirent as an off, nolvistancing + Not have been conviled of anj felony or of @ misdemeanor suspesion ofa sentoce or winning of adudcation invoWeg penury oF fase statement, nor have received 2 + Have boon tngrpiniue bythe enpoyng agency.

    You might also like