2015 PHYSICAL ABILITIES DATA FORM APPLICANT'S INFORMATION: name: Z@eherie esl _ Date:_ 5 4/74/2 Accs: ———— 25° Years __/@ Months Heigt:_@ A _taches Ge! Female weight: / FO Pounds TESTDATA Time otDay: _ 66 77 wins SSE SpuiDie Temperature: _@4 op Relative Humitiy: _/0 0% ‘TEST SCORE ‘TEST RESULTS Time Mtinsee) Timers: As SZ SE Timer wd SE aan Naneortet Adminbiawrat: 2 Chex Sega Signature of Administrator #1 ZZ SL/> 4/7 [Name of Test Adminstrator #2: S11 [eo Da Tincot Da Applicant’ Siesatare@ ZL. a ‘Comments and Observation< PHYSICAL ABILITIES TEST DATA'PORM (Continued) ‘The physical abies test you are about fo take requires a maximal effort. The time It takes to complete ‘his test wil be recorded as your best effort. Pease note that while pacing yourself may be important for, succesful completion ofthis test, your best effort is encouraged. [the applicant, acknowledge that Ihave been oriented tothe test course, given the opportunity to walle ‘trough the course and have had questions satisfactorily answered regarding the fst. APPLICANT'S SIGNATURE: ‘Iasructions to Phys Abilities Test Eralontor/Adminstrtor in Regard to Medical Symptoms or Observed Abnormalities (Pre flot te own austen bd on ore) ‘Before, during, or after the physical abilities testing dl the applicant complain of any paln, lstres, or symptom ‘psibly related toa medical condition? If so, please elaborate: ‘Was the applicant observed by you or others tobe in physial distress before, during, or after the tasting? Ifo, please explain: Di the applicant have any particular dificaty performing the physical ables testing which you, in your ‘opinion, would relate to a physical disorder? Ifo, pease explain:~ ~ 117 South Seine Asap Steet ‘Tek: (103) 836-3600 ‘Alexandsa, VA 22314 Fax: (703) 836-4280 (MORRIS & MeDANIEL, INC, 5a ingenontnniom ‘Manageneat Conran: KINGSLAND POLICE DEPARTMENT THE MORRIS CANDIDATE PROFILE SUMMARY FOR LAW ENFORCEMENT FLAG REPORT May 22, 2017 Candidate: PRESLEY, ZECH sh Test Date: May 17,2017 ‘This candidate has 10 fag(s) that should be reviewed before making a Personnel decision. Flags are noteworthy responses to specific Items, Lacs | have been involved in situations that resulted in yelling or shouting at co-workers ‘approximately the following number of times during the last two years: two. ES, IS, TW_ Except as necessary to be heard over background noise, ! have shouted at a person | a" €oig busless wih te folowing number of tes ding the lst wo yeas: Two, ES, IS, SO, WE Except as necessary to be heard over background noise, | have shouted at a fellow ‘worker the following number of times during the last two years: One. ES, 1S, TW Have you ever purchased, supplied, or sold marijuana? Yes. DAU, ES In the ast five years, | have been involved in the folowing number of accidents: 2-3. § | have committed one or more acts of domestic violence in the last five years. Yes. Di, IN Di Disc DAL-DrugiAbonet Abuse | Hinilatve N-inogrty ‘Sinterpersonal Skis | F-Mul-Tasing RECT-Racaethie/Outwal Tolerance | S-Safety SE-Sa-conficence | S0-Senice Ofentaton [Tw-Teamweork Tumover Weer ic7 117 South Saint Asaph Steet ‘Tek (703) 836-3600 Alezandeia, VA 22314 Fe: (703) 836-4280 [MORRIS & MeDANIEL, INC. ss wighorindnom ‘Management Conslats g PRESLEY = FLAGS CONTINUED: ' have past experience as a law enforcement intem, volunteer, cadet or explorer. Yes. T | have past experience as a sworn law enforcement officer. Yes. T | have past experience in private securily. Yes. T Has your automobile insurance ever been cancelled for non-medical reasons? Yes. DITHE LAW ENFORCEMENT \ CANDIDATE PROFILASUMMARY 7 Ce BIOGRAPHICAL INFORMATION SSNIDE Last Name PLEETENT eRe 9009000G009000 99909909 S8esaaee0900000 G0000000 860900000000000 9900000 8e999e090000000 0000900 $80008000000900 08090009 900900000000099 90000000 800990000000000 G0990009 $80000000009900 20080000 8000000090000 90990000 $80009000000000 00090000 $90990000990000 G9000008 §00080000999900 99099000 Boesessegsssaee G2900008 Oe09900090088 99900008 990C09000900000 90000900 S00e00000900000 00000000 $99090000000000 99000000 889900900000000 20009909 $80800000000090 GG000000 900900000000009 0999000 $80000000900000 00009009 BOOOG9BOGOGIGO_0GQBOOOO 80099000000000 G200099° $00080090000000 G6000000 9000 900000800000000 0000900 $00090000300000 80000000 ° 8 8 o ° o ® ° 8 8 8 8 ° 8 ° 8 8 ° 8 8 3 } 8 8 ° ° Date of ith Ethnicity Gender @a i) mate contin © 9200 ‘ion Aoet emit 8o00 ‘aie Anetan 9900 pe 8000 a 000 — 9900 tint 8900 8000 8009 deeo Lore: ‘This frame Sheets wai soatd aes mace do na compteTHE LAW ENFORCEMENT ‘CANDIDATE PROF lle’ SUMMARY ANSWERS ct PART #2 SSNID# feel weceoooeee | 200 ne@eo00cee0 | = seo 22680000000 400 7300800 590 21290000000 | seo zseo0000e00 | 708 25040000000 seo 2790000000 230008 22@00000000 woe0o 310008 32800000000 PARTS 33@0000 3400008 3500000 1890000000 300000 1900000000 | 2" 31700008 3800008 900008 4000008 4100 200 4308 40008 4590000 4000) 470008 1608 179900009000 CONTINUE TO NEXT PAGE+ [7 esssonsiss THE LAW ENFORCEMENT ~] ~ CANDIDATE PROFIKLYSUMMARY [eer Ssnio# 508000 500080 | 5TOOeOO s90@000 } moecoo —«- 10090000 Heo0e — 010000 | fooeeoo © tz 00008 518000 200008 63000000 nae 490000 ioe 6508000 imo8 080000 = 10500 | 8700800 2200000 e00000 = 10808 180000 190080 720800 730000 74998000 11080 7500800 11100 1690008 1200 7700® 1300 7800000 1400 7300000 1150 — 000800 11680 e100 1780 2200 1190008 #00800 118000 8400080 ee 3500080 | 86000800 eee | aoe ee. 14000008 | i508 890000 12508 |4 ~ GACP Entry-Level Law Enforcement Officer Exam Flowcis and HeBantel, inc. wg 1725800943, r 29900 90800 20089 Seooe eec80 29900 eoooe 20909 80080 Ses08 ANSWERS, 20009 e9990 0008 geoce So208 ceces Soces 20808 G0e0@ 90000 G8090 08000 08008 eo@oe 20089 12 BOESS GOGO OOOO Sheee suse SEEBR SEEKER esoe0 eeees 29000 eecee ; es BOG O8O00 Seses soces 83008 80860 RARER First Name gegogene 2900960 9990080808080000000 SOCOVSSSOOGOOOONVASD 8 ©090909000000000000 QESCCBOOTOO IOS AIRS 80000000000 2800: 3 3 3 o 3 3 3 3 et 8 Si 8 3 3 o rt 8 i ce rt 2: 2: ei 900900900000000 5 bs to = a fe S cs} Last Name @909900000 fa sseseenees 938 80. . fF segce90000 gibmoomecoee©® — fe! 8980000008 ‘qm ote = 2 [z] 9999999090 1 eens ° HBB gesessesss 2G sesssecec8 a oeeggecees af sssssesece ‘SSNIDE Ethnicity a (O afreen Anercon Some Gender Asie 0 Fenate (© Annes ian © Asie Oise~ a Mme ‘Carers fe a Pee City of Kingsland Police Department Post Offce Box 250, Kingsland, Georgia 31548, (12) 729-0284 Name Date S- 9-17 BACKGROUND QUESTIONNAIRE ‘The purpose of the Computerized Voice Stress Analysis In this process Is not to detect lies. Tt is simply to verify your integrity. Answer truthfully and completely. You may use the back of the questionnaire to further explain your answers if necessary. If you have any questions concerning ‘your background or truth verification testing, write them on the back of the page. All questions. ‘must have an answer. Do not leave any blank. If you have 2 question, then note I. (NOTE: This is your opportunity to fully explain your history. Please take advantage of this and be {as specific and detailed as possible. If you are not completely honest and up front with your ‘answers, or you intend to be Intentionally vague with your responses, the result will be termination from the employment process. Its in your best interest to disclose information and explain It, rather than omit something and it then being discovered later.) UNDETECTED CRIMES 1) Have you ever committed an t you were not caught doing, but if caught, you would have bean arrest? Yes Ro eyes, explain deta) 2) Have you ever been involved in any ofthe following? (If any yes, please Include when, where and valve) ‘A. Switching price tags No 8. Carthete No ©. Theft of car parts No 5. Robbery no Eig ome/ousines No F Embersiement ne. &. Concealed weapon no HL ives you started a [Con gomes eg 3, Leaving the scene ofan accident fe K— Counterfeting Nez Cre bombing ne RR ‘Mugging No_Z Sassou No ©. Buy, sel or possess stolen noZ— property 7 . Using stolen creat cards te, Q. Failure to pay alimony, ‘Yes_ No_Z child support L legally ebtining pubic Yex_ a assistance, workers comp, or unemployment by fraud3) 4) 5) 6 ” 8) % 40) 41) 12) 13) 14) 15) 16) 17) 18) 19) Have you ever fed an bndrgce cam that was Intentionally hed accurate (overestimating Wee losses)? Yes____ (Explain) Has a law enforcement officer e called because of some thing that you were Involved In? Yes. No. (Ut yes, explain) ‘When did you last write a check that bounced or when you knew that there were no funds to cover the value of the check? How many in a lifetime? Have you ever written a check in another person's name? Yes No. tyes, explain detals) Have you ever used» frendulent document to obtain money? Yes, (if yes, explain) Viore yorever ng S5he tn cha weapon was used? Yes___No, (yes, explain) te you ever idugrorcaurd the death of anatier parson? Yes___ (if yes, explain) Have you eyer physically abused a spouse, grfriend, boyfriend, oF child? Yes A (At yes, please explain) Ty wie aE Wee eh fore pri HL egnid tah eh A Sue physnah attention, Ti He Av. Have you ever inteptionally damaged property belonging to another person? ‘Yes. No. (If yes, explain details) Have you ever flled 3 false police report? re No, (yes, explain) What is the most serious thing you have done In your life? Acts elviving Have you ever paridpated ina riot or daturbance? Yes___No_7 (if yes, explain) Since you have been an adult (17 years old). Have you ever had sexual involvement with the age of 17? Yes__ No, If yes, how old were they? I? How old were you? ZA How long ago? 2x (Expain deta), Have you ever sexuply assauted anyone? yen eM yes exon deta) Have you ever engage in prosttutin or ever used the services ofa prostitute? Yes___No__ (af yes, explain) No_Z (If yes, ve detals) Have you ever been questioned py a law enforcement agency as @ SUSPECT In an Investigation? Yes___No, Have you ever been accused of misconduct? Yes, ‘Other than what has already been covered, have you been involved in anything that you ‘could have been arrested for? Yes“ No___(IFyes, explain detals) Re yon back mysell and o Areal hunk at tHe side OR a consy Sind. ge 2-08820) Have you ever belongetwe, associated with anyone belongs, any organization, past or present, that would place the integrity of the Kingsland Police Department In queston? (e.9., KKK, Naz! organization, Gang member, organized crime) Yes No (If'yes, explain deals) 21) Do you now, or have ever had regular associtions with persons whom you knew, or should have known, were under criminal Investigation, or who had 8 reputation In the corrmunity or with law enforcement agencies for Invalvement in criminal behavior? ‘Yes. No. (If yes, explain details) MILITARY 22) Have you ever served in any miltary organization ofthe United States? Yes Nox If yes, what branch? 23) hat type of aacharge dé you receive? Yonorable_Dishonoree_ ther than honorable Generel__- Otner2// 24) Have you ever been court- marshaled, tried on charges, or were you the subject of @ summary court, deck court, Captain's mast, company punishment, or any other type of disciplinary action while a member of the armed forces? Yes,” No -2(If yes, explain etals) 25) Are there any incidents concerning y6ur military career that could possibly affect this ‘examination? Yes No_/~ (Explain) [ARREST RECORD 26) Have you ever been arrested, charged, or detained by a law enforcement agency? (Include any arrestin which the charges were dropped, reduced, found not gully, or in which the records were sealed or expunged) Fallure to do so could result in termination ofthe emploympet process. (A Notice to Appear Is considered an arrest and must be liste) Yes 7 No. Citys, ean deal onde te ghrge,arsting agerey, ate and the final disposition of the case)CCs0 \< eller tot» Partin eld, syatim. To ma? of “nn te sptoles, Cvyttis efe wu dap ar enprad. 27) Have yoyever served probation, parole, community service, or community contro? Yes_Z_No___ (if yes, explain) wen’ tw ja. mible abot A" flloy uy 34 Sih. (28) What fines have you been required to pay, and were they paid on time? (Other than traffic) 29) Have you ever been fingerprinted by a law enforcement agency? Yes_ Vs (At yes, provide agency, date, and the reason why you were Aingerpinted) C30 Cebvagad\ ex gap Ego) DRuG USAGE 30) How many times In your life have you used marijuana? (Please include approximate dates and how many times weekly, monthly, etc.. sy aad riddle sclwnl. 31) When was the last time you used marijuana? dolor tel) 32) Have you ever used inh nts, or anyother legal substance, to get high? (Paint thinner, ‘aerosol, glie) Yes No (IF yes, explain) rege ot~ ~ Have you ever driven g motor vehicle while under the Influence of illegal drugs? 33) Yes____No = (If yes, explain details) 34) Have you ever used any of the following? (If yes, include number of times and the date last used) aD speed 8. —f Barbtuates (downers) ¢. [= Amphetamines (uppers) D. Rush . T— Quaatudes F Usp . [= Hash H. XI ice or Methamphetamines 1 Mushrooms x (Other persons prescription kx. 1 Mescaline L Steroids M, [= PCP (angel dust) N. [crack 0. = cocaine P. [Heroin Q. 1 Ecstacy R. —[— amiinirates s. Designer drugs 7. 1 peyote ‘And all other illegal substances not listed. 35) Have you ever been jovolved in the purchase of any illegal drugs? (Any amount from a joint toa kilo) Yes No___ (if yes, include type of drug, the amount, the reumstances, afd the last Ue) Len Ae dire ef Masts. 35) Have you ever been involvesf the sale of illegal drugs, either directly, or Indrecty? ( Any amount) Yes__No_ (it yes, include type of drug, amount, the circumstances, and the last ume) 36) Have you ever benefited from the safe of legal drugs, to Include money, free drugs, or sexual favors? Yes __No_ (Note i you received any money from a frend or family ‘member involved in drug sales indirectly, list here) 38) Have you set up a drug desl? Yee_ No _<“(if yes, explain) 39) Have yowGver been inthe company of person using egal rugs? Yes_< No ___ (If yes, explain) Om a tuko T way feteidy the arbor and a coin Sead Srurtas Soe tye oF Ph 40) What is th unt of money you have spent an legal drugs in your life? 32h dacs 41) Have you ever sgafen money or drugs from a drug desler? Yes "No. (if yes, explain) 42) Have you ever usgé‘medication from another person's prescription to get high? Yes __No_ (if yes, explain) rage 4-088~ ~ 43) Have you ever trigd-to grow or cultivate any illegal drugs? fes_No_~ (If yes, explain) 44) Explain, in detal, any other information related to illegal drug use or Involvement which has ‘not been covered, to Include transportation, manvacturing, etc, THEFTS 45) Estimate the total amount of merchandise, tools and equipment that you have taken: —— $50,000 $5,000 __$500 $75 = $40,000 = $4,000 $50 = $30,000 = 3000 $25, = 320/000 = gi000 0 — $10,000 = $1,000 $5 PA ab wok 46) Name the single most expensive Item you have ever taken. Ttem_2/2- amount date___ 47) Have you ever taken anything or shoplifted anything from a business? {Include personal and employee thet) Finis Ulan tat amt 12 - 48) Have you ever been wht anyone wha was staing merchandise or eupment? Yes____No (Cf yes, explain) 49) Have yoy-ever taken anything from a previous or current employer? Yes_7 No (Explain) fins 50) Estimate the amount of cash that you have stolen In your entire life and explain in each Incident. (Include personal cash thefts from family or friends, and cash from employers, ‘along with any other incidents) Si pean 51) Have you ever purchased, pprfned, or sold an item which you knew or should have known to bbe stolen? Yes ___ No_ (Explain) EMPLOYMENT HISTORY 52) Have you ever bger’terminated or asked to resign from a job? Yes__No_— (if yes, explain) 53) Have you ever been disciplined by your current or previous employers? Gf discipline was by a law enforcement agency, refer to law enforcement experience questions.) Yes__No____ (If yes, explain details) 54) Have you ever resigned or been given the opportunity to resign from a job in which you were under investigation for policy violations or misconduct? Yes No_~“ (iF yes, explain) 55) Did you lst all of your jobs for the past ten yeprion your employment application to Include part-time and temporary jobs? Yes 2 No__ DRIVING HISTORY 4 56) Has your license ever been suspended or revoked? Yes _No_“ (Please explain) Page-5-088~ 57) What states other than Georgia, have you hi conse in? (List all states and Include temporary and learners permits) '58) _ List al traffic citations that you have ever received. 5) Have you ever been ina trafic acident that was your fault? Yes No. (tyes, explain) Has your auto Insurance ever lapsed? Yes_/~No___ (If yes, explain) Za -b- 60) How many times have you driven a vehicle while under the influence of elchel, where stopped, you could have been arrested? OMe iA Zaft When was the last time? Hla bol Lisl ob slo fore ead 61) Have you been involved in any other acts, involving alcotol that could be considered criminal? Yes ___No__-~ (IF yes, explain detals) FINANCIAL HISTORY See errr eee 62) Have you ever ad anthing repseesnt Yes“ vo (ye, en Sn 64) Have you ever been involved in any civil actions? Yes _ No __=if yes, explain) 65) Are you currently more than three months behind on your bills? (If yes, explain) 66) Are any creditors pursuing you for outstanding debt? Yes _~ No ___ (if yes, explain) 67) Arethere any franca oblgations or bls thet Mens teeta fel hat you ae ‘Rot responsible for? Yes __ No (IF nat, explaln) 68) Have you ever are you currently responsible for child syppart payments? Yes__No_“Are the payments current? Yes _ No 69) gurus the amount of debt you owe, not incusng house and car payments /er used to include maiden, nick names, married and legal name changes. Zech (QUESTIONS FOR CURRENT OR FORMER LAW ENFORCEMENT OFFICERS If you answer yes to any of the following questions, please explain and provide details to include where you were employed at the time and date of the occurrence, Use the back of the questionnaire pages if necessary. e 1) Have you ever accepted a cash bribe or gratuity? Yes _ No 2) Have you ever taken (stolen) anything from an investigation site? Yes, No. ZL 5) Have you averse om apc dataner Yas 80” Pane 6-0884) Have you ever been itwpitigated or accused of using excessheeforce? Yes__No-~ '5) Have you ever used more force than was necessary to subdye’ another person or have you ‘ever witnessed an excessive force situation? Yes No 6) Hae you err ack hrc cotane wor Yer to No 8) Have you ever falsited any typeof oficial report? Yes __No 7) Have you ever handled evidence in an illegal manner? Yes 9) Have you ever seed your postion asa law enforcement officer for personal gan? Yes__NoZ 10) Have you ever been the subject of an internal investigation? Yes __ No. (AF yes, Ist n chronological order, short eyrepeis and outcome, to nude dpine received) BE SPECIFIC 11) Do you have any active or pending intemal investigations or discipline? yes Noe 412) As a law enforcement officer, have you ever been disciplined? Yes “No _ (Please include orl and written reprimands, suspensions, and anything that would curently or have been purged from your personnel file)Vebl hangs . 13) ave you ever aten anything rom pace ht hs akeady been burglar? (es __ No (Give dollar amount and st ems) 14) Have you ever tgkeh cash, property, or valuebles from a dead body? Yes." No“ yes, explin) 15) Have you ever | f cash, property, or valuables from an intoxicated person? Yes. No 16) Have you ever lied to @ police supervisor? Yes _ No .<~ 17) Have you ever told a friend, acquaintance, or relative about an investigation involving them? Yes__No_~ 118) Have you ever been provided or pald to provide confidential information to an tunauthorized person? Yes __ No 19) Have you ever removed, destroyed police records or fles? Yes __No_<~ 20) Have you ever disclosed the identity fenial Informant to an unauthorized person? Yes __ No, 21) Have you ever exposed the identity of prrundercover faw enforcement officer to pesto ree a 22) Have you ever ied under oat? Yes No 23) Since becoming =f ‘enforcement officer, have you committed a felony? ea 24) Have you used your position as a law enforcement officer to take sexual ‘advantage of anyone? Yes _ No 25) As a law enforcement officer, have you engaged in sexual activity while on duty? Yes _ No 26) Have you ever been involved In a shooting Incident? Yes _27) Have you ever been thiswlbject ofa Grand Jury inestigatiore/es No 28) Have you ever been subject to any chil lawsuit, prior or pending? Yes No <~ 29) Have you ever been involved in any on-duty motor vehicle accident? Pleas@tist each accident and include was determined to be at f No = 30) Have you ever had sex with 2 relative? Yes _Ne 31) Have you ever had sexual Involvement with a juvenile? Yes _ No 32) Since becoming-Slaw enforcement officer, have you used any illegal drugs? Yes __No 238) Have you ever used alcohol or drug wile on duty? Yes No —~ 34) Have you ever showed up for duty-vhile stil under the Influence of alcohol or drugs from the night before? Yes__ No _/ (If yes, give date of last time) 235) Explain any crcumstances or Incdents in which yeu have been involved In 2s aw enforcement officer that could have 2 negatwve Impact on Your employment withthe Kingstend Police Deportment. * lh ADDITIONAL QUESTIONS FOR OFFICERS WITH CORRECTIONS EXPERIENCE 1 you answer yes to any ofthe following questions, please explain and provide details to include where You were employed at the time and the date ofthe occurrence. Use additional paper or the back of thls questionnaire H necessary. 1) Have you ever Introducgs contraband into correctional facil for an Inmate or another officer? Yer Noe 2) Since becoming a correctional officer have you 6d sexual involvement with an Inmate or another officer while on duty? Yes __ No 3) Have you ever accepted a bribe from an inmate? Yes __ No 4} Have You ever hpdor majtlned friendship or relatonahip wth an inmate ater they were released? Yes No 5) Have you ever Kept, used, or glven away an Inmates property? Yes __No.<<~ A Aah schol Grek gut arreitd , Cres vere dred, L St Stok wih bin i Z see Aim ot in ton. | CERTIFY THAT THE ABOVE INFORMATION PROVIDED IS TRUE AND CORRECT. I HAVE BEEN COMPLETELY TRUTHFUL IN MY ANSWERS TO THESE QUESTIONS. I UNDERSTAND ‘THAT INTENTIONALLY EXCLUDING REQUESTED INFORMATION OR MISLEADING THE FACTS, MAY BE GROUNDS FOR TERMINATION FROM THIS EMPLOYMENT PROCESS. Page -8-0t8City of Kingsland Bolice Bepartment 02250, Kingsland Cass 3188 st Pos: Offi ot Truth Verification Release Farm 1 Zekvial, Sreshy do hereby voluntary, without duress, costo, promise, tenard'or rn, submit to examination byte vlee Stress shale nth veriation technique and relae, absolve od forever held Feemies tye AETV and Kingsland Palle Geparment, 1's servants, agets end Sryone aang in Us beh fram ay and al esi, eeands or aber Semages om ony meter, act or tg sing ofthe aforesaid examination, I Uncestna tt tis excrinaton fiestas and reas in possesion of the Kinghorn See Departmest el mateal recordings an al ater Gecamons for the purpose of tetany ance ang Sinan Belle Ge — Dae _¢ S-/7-/2 Dui fe 79“Oe City of Kingsland EY POLICE DEPARTMENT CE DEPARTMEN Miranda Rights Waiver mas 2)IMAVE THE RUG TO REMAIN SLENT 2) ANYTHING ISK CAN BE USED AGAIUSTME IN A COURT OF AW 3) HAVE THE RIGHT TO TALK TOA LAWYER ANO HAVE HIV PRESENT WITH ME WHILE AM BEING QUESTIONED 20 2}IF CANNOT AFFORD TO HIRE A LAWYER, ONE W/UL BE APPOINTED TO REPRESENT ME BEFORE ‘ANY QUESTIONNG é 5)1CAN DECIDE ATANY TIME TO EXCERSIE THESE RIGHTS AND NOT ANSWER ANY QUESTIONS ORMAKE awe STATEMENT if | UNDERSTAND MY RIGHTS. HAVING THESE ALT IMO, 1AM WILLING NOW TO TALK ABOUT Cus ‘OF WHICH IA SUSPECTED. | HABE NOT BEEN THREATENED, WAVE NOT BEEN PROMISED ANTTTNG, "AVE NOT BEEN FORCED IN ANY WAY TO ANSWER QUESTIONS OR MAKE A STATEMENT. ‘net ONE: SUSPECT OR APPUCANT os 7 SIGNATURE Zechicul, Prerky WAS ADVISED OF HB/HER BY ME AT THE TIME, OATE AND LOCATION SHOWN BELOW. HESHE IS FASELY AND VOLUNTARILY WAVED HS/HER RIGHTS AND AGREED TO ANSWER QUESTIONS ANOVOR MAKE A STATEMENT, Z, / TFRCERCHATORE are S217 rime 24/0 puace_#t, wae Zeckasel didly oxreor snr Se 10 ace 2S navecommueren 1% YEARSOF SCHOOL ome aot: A oe ss waor 60 wee 20S ann Prion os Lenn rrr OP case now THAT A laid f oom |S AMEMBER OF THE KINGSLAND POLICE DEPARTMENT. ‘OFFICER'S NAME Ze —aktisseaE —— wowsOral Interview Evaluation Worksheet (Non LEO Applicants) Dae 2, cana To ere {OD How, {f,2017 oon Sepa GENERAL QUESTIONS ABOUT APPLICANT. ‘Note: The following questions are for the purpose of obtaining personal background Information. 1, Tellus about yourself, What is your background? Bvaluator's notes: Evaluatorsscore: 1234 2. What do you lke to do? What are your hobties?3. Why do you want to bea Kingsland Police Officer? When did you decide on this, career? Evaluator’s notes: Evaluators Score: 12 34 (5 4. What isthe job ofa Police Officer? Evaluator’s notes: Evalustor’sscore: 1234 Sx Inyour own words, what do you think qualifies you to bea police officer? Evaluator’s notes: (Work experience, law enforcement experience, education, te.) Evaluator's soore:_1 304 Ss ~S— Have you applied with any other law enforcement agencies, and if so have you ‘been tured down (why)? ‘Evaluators notes:~ A, ow fr do you wana go inte pte wa? Where do you se Jounelfin3 yeas? valuator’s notes: Evaluator’sscore: 1234 ‘\ Have you ever had any difficulty with or been arrested by any law enforcement teensy cere ajaveal oan adul? Evaluator's notes: Evaluator’sscore: 1 (2)) 345 9. What do you say when you dont know an answer to a question? Evaluator's notes: Evaluator’s score: 1234 ee tuo Evalustor’s score: 1234 2 11. What word would best describes you in a positive way? A negative way? Evaluator’s notes:Evaluator’s sore: 1 34 5 12, you sew your partner or another officer steal something what would you do? Evaluator’s notes: Evaluatorssoore: 1234 \g. tp tere rob ted nate tel dt noe Evaluator’s notes: Evalustor’sscore: 1234 SAretere any lv wich you fe you could nfs in god ath? Evaluator’ notes: Evaluatorssoore: 1234 Ng. Whit is your opinion on the use of Marjane? valuator's notes: Evaluator’ score: 3 4 5YA Wonton ase fe cfs megs? valuator's notes: Evaluator’ssoore: 1234 17. _Ifyour superior officer gave you an order which you felt was wrong, what would you do? Evaluator's notes: Evaluator’s score: _1 34 5 Ya, maou rt eer soe Bvaluator’s notes: Evaluato’sscore: 1234 IQ, Have you ever been fied, or pressured to leave a jobin the past? so expan Evaluator's notes: Eyalustor’sscore: 1234PRESENTATION 20, (Note to evaluator- During the interview, please male these observations and ‘grade accordingly) Dositeonitaepakinmminanaiiowiet «1:23 4) Isteanddaecnreouinterconentin? = «12:3: Does tecntecmeyiormain sixty? «122 4) Ist candidat neat en ell goose? 12346@ ‘Bvaluator’s notes: Add the 4 grades awarded above and divide by 4. Circle below the closest grade for an average. valuator’s average score for above Note: When questions are completed, explain that his interview was nota pass fal, «and that we are only trying fo identify knowledge levels and experience. Also suggest ‘that f any of these tople areas were a problem forthe applicant, they may consider ‘researching into those areas they felt ss knowledgeable about.Oral Interview Evaluation Worksheet (Non LEO Applicants) pute: __5~/$-17 Candidate's Total Seore_14 Candidate: Zach Presley Evaluator: _ Benoit GENERAL QUESTIONS ABOUT APPLICANT Note: The following questions are for the purpose of obtaining personal background information. 1, Tellus about yourself, What s your background? ne valutor’ notes: motte cond offi’ Eyalustorsscore: 1234 2. Whatdo you keto o? What are your hobbies? Bvauaorsotes: Fo NY Evalustor’sseore: 1 234 (53. Why do you want to be a Kingsland Police Officer? When did you dee on tis career? Evaluator's notes: Evaluator's Score 1234 Whit isthe job ofa Polie Offices?” | Segve Evalutorsnotes: “Yeore® Evalustor'sscore: 1234 SS _ Inyour own words, what do you think qualifies you to bea police officer? Evaluators notes: (Work experience, law enforcement experience, education, etc.) Evaluator'sscore:_1 23 5 Sm Have you applied with any other law enforcement agencies, and if so have you been tured down (why)? Evaluator’s notes: S}-, AY? Evalustorssoore:_ 1 234 GHow far do you want to go inthe police work? Where do you see ‘yourself in 5 years? Evaluator's notes: Evaorsscore: 1234 N ‘Have you ever had any difficulty with or been arrested by any law enforcement agency citer os ajuveile or aan aul? valuator’s notes: Bahaorssor: 1 2 3 4 @ 9. What do you say when you dont know an answer to a question? hones Evalunorenotes “OC Evaluatorsscore:_ 1234 reer Evalustor’s notes: Evaluators sore: 1234 11, What word would best describes you in a postive way? A negative way? Bvalustor'snotes: Cg \f- nor CochisanEvaluator’sscor: 123 12, Ifyou saw your partner or another officer steal something what would you do? Evaluators notes: Evalunlo’sscore: 1234 eee renner lrg Evaluator’s notes: Evaluator’sscore: 1234 J. Are there any laws which you fel you could ot enfore in ood fh? Evaluator’s notes: Evalustor’sscor: 1 234 Se voy eps coe tsa? tte Evaluato’sscore: 1234Ya Wotton ssp tesco omens? [Bvaluator’s notes: Bvaluator’sscore: 1234 17. Ifyour superior officer gave you an order which you felt was wrong, what would you do? Evaluator's notes: Evaluators score: 1234 Ne —— Was Evaluator's score: TR Have you ever ben fired or pressured, to eve ajob inthe past ?Ifso explain Beata nts) YPRESENTATION 20. (Note to evaluator- During te interview, please make these observations and ‘grade accordingly) Doesthe cama speak in en ndestmisiewie? 1 23 @ 5 Inte cnt coreousintircomernion? = «1 2-3 4 @) poetecntstecmey ntmaimceaiyt? «1: 2:3: DS Ise anit et nd wel pore? 123498 [Evaluator’s notes: Add the 4 grades awarded above and divide by 4. Circle below the closest grade for an average. Evalustor's average score for above ‘Note: When questions are completed, explain that this interview was not a passfil, ‘and that we are only trying to identify knowledge levels and experience. Also suggest that if any ofthese topic areas were a problem forthe applicant, they may consider ‘researching Into those areas they felt less knowledgeable about.Oral Interview Evaluation Worksheet (Non LEO Applicants) Date: _5}18)> ‘Candidate's Total Seore: 94) ‘Note: The following questions are for the purpose of obtaining personal background information. 1, Tellus about yourselé, What is your background? Evaluator’s notes: 2, What do you like to do? What are your hobbies? Evaluator’s notes: Evaluator’s score: 1234‘Why do you want to be a Kingsland Police Officer? When did you decide on this career? Evaluator’s notes: Evaluators Score: 1234 ‘What is the job of a Police Officer? Evaluator’s notes: Ss. Inyour own words, what do you think qualifies you to be a police officer? Evaluator’s notes: (Work experience, law enforcement experience, education, atc.) Evaluator's score: 123 5 6~_ Have you applied with any other law enforcement agencies, and if'so have you ‘been turned down (wy)? Evaluator’s notes: Evaluator’s score: 123 3How far do you want to go in the police work? Where do you see ‘yourself in 5 years? Evaluator’s notes: Evaluators score: 1 23 5 ‘ ‘Have you ever had any difficulty with or been arrested by any law enforcement agency ihr a juvenile or as an aul? valuator's notes: Evaluator’sscore:_ 123 5 9. What do you say when you dont now an answer to a question? Evaluators notes: Evaluator’sscore 1234 » Have you ever been in an emergency situation? Tell us what you did? valuator’s notes: Evaluators score: 123 5 11, What word would best desribes you ina positive way? A negative way? Evaluator’s notes:Evaluator’ssoore: 1234 12, Ifyou saw your partner or another officer steal something what would you do? Bvaluator’s notes: Evaluator’s score: 123 een reese aaa Lisrhow Evaluator’s notes: Evaluator’sscore: 1234 J. Arete any lave whch you fel you could ot enfin god fit? Evaluator’s notes: Ng. Whats your opinion on the use of Marjane ? ‘Bvaluator’s notes: Evaluator’s score: 123 5® ‘Would you accept free coffee/cokes or mealuleigarettes? Evaluator’ notes: Bvaluator’sscore: 1234 17. Ifyour superior officer gave you an order which you felt was wrong, what would you do? Evaluator’s notes: Evaluator’s score: 123 5 Ya, what would yourlaseueat employer sy sou you? valor tes: Evalustor'sscore: 1234 1S. Have you ever been fred, or pressured to eave jb inthe past 750 explain. Evaluator's notes: Evalustor’ssoore: 1234PRESENTATION 20, (Note to evaluator- During the interview, please make these observations and. grade accordingly) ‘Does the candidate speak in an understandable voice? «= 1 «2:3 @MS Is the candidate courteous in their conversations? 123@5 Does the candidate convey information clearly? 123@s shania nat ed vel pone? 12346@ [Evaluator’s notes: Add he 4 grades awarded above and divide by 4. Circle below the closest grade for an average. Bvalustor’s average score for above @ ‘Note: When questions are completed, explain tha this interview was not a passfil, ‘and that we are only trying to identify knowledge levels and experience. Also suggest that if any ofthese topic areas were a problem for the applicant, they may consider, ‘researching Into those areas they felt less knowledgeable about.Oral Interview Evaluation Worksheet (Non LEO Applicants) pate: S117 Candidate's Total Score:_ BE ‘Note: The following questions are for the purpose of obtaining personel background information. 1, Tellus about yourself, What is your background? valuator’s notes: Byalustorsscore: 123 3 2. What do you like to do? What are your hobbies? Evaluator's notes: Evalustor’s score: 123 53. Why do you wantto be a Kingsland Police Officer? When did you decide on his career? Evaluator’s notes: Evaluator'sScore:_1 234 ‘What is thi job ofa Police Officer? Evaluator’s notes: Evaluator’ssoore:_ 123 5 sx Inyour own words, what do you think qualifies you tobe a police officer? Evaluator’s notes: (Work experience, law enforcement experience, education, te.) Evaluator’ssoore:_ 123. 5 Se Have you applied with any other law enforcement agencies, and if so have you ‘been tamed down (way)? _Evaluator's notes: Evalustor's score: 123. 5How far do you want to goin the police work? Where do you see yourselfin $ years? Evaluator’s notes: Evaluator’s score: 12. 45 _s ‘Have you ever had any difficulty with or been arrested by any law enforcement agency either as a juvenile or as an adult? Evaluator’ nates: Evaluator’sscore: 123. 5 9. What do you say when you don't know an answer to a question? valuator’s notes: Evalustor’s sco: 1234 ee errr eeere Bvaluator’s notes: Evaluator’s score: 1234 11, What word would best describes you ina positive way? A negative way? Evaluator’s notes:Evaluator’sscore: 123 3 12. Ifyou saw your partner or another officer steal something whet would you do? Evaluator’s notes: Evalustor'sscore:_ 1234 smc enn ina ee teers Evaluator’s notes: Evaluator's score: 12 4 Sq. Arethere ny va wich youfel you coulda enforce in good ti Evaluator’s notes: Evaluator’sscore: 1234 Ng ‘What is your opinion on the use of Marijuana ? Evaluators notes: Evaluator’s score: 12 45Ye, Watsons cts meine? ralato’s notes: Evaluators score: 1234 17. Ifyour superior officer gave you an order which you felt was wrong, what would you do? Evaluators notes: Evaluator’sscore: 1 234 YA, Wa wren et tse Evaluators score: 1234 1a, Have you everbeen fired, or ressred, to leave ajob inthe pst? Ifo explain. Evaluator's notes: Evaluator’s score: 1 234PRESENTATION 20. (Note to evaluator During the interview, please make these observations and. rade accordingly) Does the candidate speak in an undersanécblewoiee? 1-2 @ 4 $ Ts the candidate courteous in their conversions? 123@5 Does the candidate convey information clearly? 123@5 Tse candidate neat and well goomed? 123@5 ‘Evaluator’s notes: Add the 4 grades awarded above and divide by 4. Circle below the closest grade for an average. ‘Note: When questions are completed, explain that this interview was nota passfal, ‘and that we are ony trying to identify knowledge levels and experience. Also suggest that if any ofthese tople areas were a problem for the applicant, they may consider researching into those areas they felt less knowledgeable about.Kemeth Sith Sr Mayor Dares! Gris Chief of Police City of Kingsland Police Department Office of Professional Standards Post Office Box 250, Kingsland, Georgia 31548 (912) 729-8257 Employee Service Agreement ‘This Agreement made and entered into this 24% day of May 2017, by and between the Kingsland Police Department hereinafter called the “Department” and Zechariah Presley herein called the “employee”. WHEREAS the Department deems it necessary and desirable to retain the service of employees ‘who are competent to perform the mental end physical functions and duties of Police Officer, ‘and ifthe employee has been deemed qualified to perform such services forthe City of, Kingsland Police Department. NOW, therefore, for and in consideration of the mutual promise herein contained, the Department and employee agree as follows; 1 loyment ‘The employee fully understands thatthe City of Kingsland is an “At Wil 8s such can terminate the employee at any time without reason or cause, ‘employer and I. Conditions of Emplovmen A. Theemployee agrees to, ‘Successful Completion of the Georgia Basic Law Enforcement Academy. Maintain a state of Georgia driver’ license Maintain Peace Officer and Training Council certification. ‘Meet and maintain standard passing ratings on annual performance evaluations. ‘Meet and maintain a standard passing score on agency PAT. ‘Meet and maintain a standard passing score on annual firearms qualifications. as all other tests deemed appropriate by the Chief of Police. Follow/abide by all portions of the Departmental Standard Operating Marval.‘The employee agrees that the Kingsland Police Department may elect to send the employee to basic mandate and/or such specialized technical training schools as. will enhance the employee's skills and job performance. The employee further understands that these skills are acquired ata considerable cost and in consideration thereto; that upon employment the employee hereby agrees to reimburse the Kingsland Police Department forthe total expense of training, to include salaries or if employed by another Georgia law enforcement agency, as prescribed in OCGA 35-8-22. The expenses which it incurs as a result of any ‘Basic Mandate Training or other formalized required training should the employee's employment be terminated for any reason within a two (2) year period of time after fully completing said school or course of training if requested to do so. The initial fifteen (15) month period willbe billed a fll cost andthe latter nine (9) month period will be billed at half cost. Employee also agrees that failure to meet standards in any ofthe above listed ‘conditions will be eause for termination from employment with the Kingsland Police Department. ‘Employee understands that this Service Agreement is mot to be construed to indicate thatthe employee is guaranteed any specific term of employment by signing this form. have read and understand this document and agree as a condition of employment to maintain those standards as stated in Section Il (Conditions of Employment), Kingsland Police Department, Kingsland Georgia. i b-45-Q beKamath Sah, Dory Gifs “Mayor Chiefof Police City of Kingsland Police Department Office of Professional Standards Post Ofice Box 250, Kingsland, Georgia 31548 (012) 729.8257 ‘TATTOO POLICY ACKNOWLEDGEMENT 1_Lecharial fren have read and understand that the ‘current policy of the Kingsland Police Department as outlined below forbids the display of any tattoo below the standard short sleeve uniform shirt or department polo style shirt at anytime. Several options are listed below to remedy this if it applies now or in the future, In addition any form of “body art” as described below is prohibited from display to the public while in uniform or representing the Kingsland Police Department at any function. 2012-2013 KPD Standard Operating Procedures Manual Chapter 7 8. Tattoo's Its the poliey of the Kingsland Police Department that all uniformed Employees and explorers maintain the highest standards of professional appearance when interacting withthe public and representing the Department. All uniformed employees and explorers are prohibited from displaying any body art, tattoos), intentional scarring, mutilation, or dental ornamentation while on duty or representing the department in any official capacity. Any currently employed uniformed employee and explorer with existing body art, tatoos), intentional scarring, or mutilation that is visible shall Ihave the following options:1. Uniformed employee shall cover existing body art, tattoo(s), intentional scarring, or mutilation by wearing the long-sleeve shirt or compression sleeve. 2. Cover the existing body art, tattoo(s), intentional searring, or mutilation with a skin tone patch or make-up. 3. Have the tattoo(s) or brand(s) removed at the employee's expense. Body art, tattoo(s), brand(s), intentional scarring, and/or mutilation that is not able to be covered or concealed is prohibited. This includes, but is not limited ‘foreign objects inserted under the skin, pierced, spit or forked tongue, ‘and/or stretched out holes in the ears. Uniformed employees and explorers shall not have any dental ornamentation. ‘The use of gold, platinum, silver, or other veneer caps for the purposes of ornamentation are prohibited. Teeth, whether natural, capped, or veneered, shall not be ornamented with designs, jewels, initials, ete. BE Z Knox Witness oeGEORGIA CRIME INFORMATION CENTER AWARENESS STATEMENT ‘Access to Criminal Justice Information, as defined in GCIC Couneil Rule 140-1-02 (amended), ‘and dissemination of such information are governed by state and federal laws and GCIC Councit Rules. Criminal Justice Information cannot be accessed or disseminated by any employee except ‘as directed by superiors and as authorized by approved standard operating procedures which are based on controling state and federal laws, relevant federal regulations andthe Rules of the ‘GCIC Counc (O.CG.A. §35-3-38 establishes criminal penalties fr specific offenses involving obtaining, ‘same statute establishes criminal penalties for disclosing or attempting to disclose techniques or ‘methods employed to ensue the security and privacy of information or data contained in Georgia ‘criminal justice information systems. ‘The Georgia Computer Systems Protection Act (0.C.G.A. §16-9-90t seq) provides forthe protection of pble and private sector computer ystems, including communications inks to suet computer systems. The Act establishes four rimnel offenses, al major felonies, or ‘violations ofthe Act: Computer Theft, Computer Trespass, Computer Invasion of Privacy and ‘Computer Forgery. The eiminal penalties fr each offense caries maximum sentences of een (25) years in prison and/or ines up to $50,000.00, a5 wel es possible civil ramiiations. The ‘Actaloesublishes Computer Password Disclosure as a criminal offense with penalies of one (1) yearin prison and/or 8 $5,000.00 fine. “The Georgia Criminal Justice Information System Network Is operated by the Georgia Crime Information Center in compliance with O.C.G.A. §25-31. All daabeses accesible via CS "Network terminals are protected by the Computer Systems Protection Act. Similar ‘communications and computer systems operated by munilpaVcouny goverment ar also protected by the Act By my signature below, I acknowledge that have read and understand this Awareness Statement. vinenane. Zecharil, Licbyy set LQ bs Reviewed 2013148 Revised 2010Darn. Gris. Mone Pes Chief of Police oat Asst Chief of Police City of Kingsland Police Bepartment Post Office Box 250, Kingsland, Georgia 31548 (912) 729-8254 Fax (912) 729-1750 Oath of Office 4 Zeelasc\frléa —dosoemaly sven ha | il hilly and impartial ischaae the dutes ofa swor li enforcement oficer ofthe City of Kingsland, Georgia othe best of my skill and ability, agreeable to the ordinances ofthe suid city, and the laws and Constitution ofthe State of Georgia and ofthe United States, an Iwill obey ali policies and procedures of the Police Department and te City of Kingsland, Georgia and all ordinances ofthe City of ‘Kingsland, Georgia andthe laws and Constitition ofthe State of Georgia and the United States ‘both while on duty, and offuty, and Iwill fithflly and impartially carry out the instructions and orders ofthe officers appoinied over me, o help me God 1 do further sweat or affirm that I am not the holder of any unaccounted for public money due this stale or any political subdivision or authority thereof; that {am not the holder of any office ‘of trust under the government of the United States, any other state, or any foreign state which, by the laws ofthe State of Georgia, I am prohibited from holding; and that I am otherwise qualified tobe a police officer according tothe Constitution and laws of Georgia. | accept the Law Enforcement Code of Ethics ofthis department as my standard of conduct while ‘on and off duty and swear to faithfully abide by and defend the same, BEA | Signature =KINGSLAND POLICE DEPARTMENT POLICE STANDARD OPERATING PROCEDURES MANUAL RECEIPT FORM Zale al. eb. do hereby certty that | have received or have access to a copy of the 2012 Standard Operating Procedures manual for the Kingsland Potce Department. | further certify that | will carefully read and abide by the contents ofthe Standard Operating Procedures manual. | so understand that in carrying out my duties and responsibilities as an employee of ‘the Kingsland Police Department, my conduct and actions will be governed by the Policies and procedures contained inthe Standard Operating Procedures manual. | further understand that violations ofthe Standard Operating Procedures may be cause for dscipnary act incuding termination of my employment GA CE ature Employes) Date 6S6-/> ‘Signature (wetress) Date (Tobe signed and tured in to the Office of the Chief)Policy Receipt Acknowledgement for the Social Media Policy ‘Thave red and been informed about the content, requirements, and expectation of the sci media ple for employees ofthe Cy of Kingsiand, Georgia. Thave recived a copy ofthe pley and I ‘gree to abide by the plley guidelines asa condition of my employment and my continuing ‘employment wth the Cy of Kingsland, Georgia. {understand that iT have questions, 8 any time, regarding the soc meds policy, wil onaut with iy immediate supervisor or my Human Resources department. Pease read the soil media policy carey to ensure that you understand the pecy before signing thls document wv esi a trvoya ens tame: Zeclene ily ote: 6° 5Georgia New Hire Reporting Form Send competes ferme “Tonsure te highest vl of accuracy, pe prt ety SER BeESER Pram Best Bont GA 30366-0728 a eee om FS (8) 25 8 re tax ne 541-0821 alale 11213 EMPLOYER INFORMATION Ferlerl Employer ID Number (FEIN) _ (pre or e sne FE a spn on yrs ut ep sos ove oS G1 GletereTstorr) Mutipe medical insurance: YN [NT — Insurance Company Name (favelbe to the empoye) Vf ovaablfteec: VN Employer Git Employer State: Zp Code (5 di): KI [NT Gis [te Ja[NJo I GTA] (aliistaTa} Employer Phone: Exiention: Employer Fax zit lelelel ls PIREFaEAPSCSEACEERE | EMPLOYEE INFORMATION Employee Social Security Number (SSN): Employee Starting Salary (Monthly):* = Sa [ oo GleleIlaeR Tale TTT TTT TTT 7 Eplyee Losi ae rarararararat COLE rrrr rrr Eneloree aos a ame TT ] Employee City: Employee State: Zip Code: = Datof Hee Dae of ith ‘ait Day of Wore? Cel T/T T7) & Bilt) CLTITiTtT) Ndi nuance Conary Name" *optional Reports must be submited within 10 days of dato of hire or rehire Questions? Call us at (404) 525-2985 or toll-free 1 (888) 541-0469 5 i ovc20 Ml‘Seta 1 EMPLOVER INFORMATION ey sy psi he Reinet Pn af Kingaland, G2orgin ert Eagle Becta etl Red Ene Bs ar ORS oH Sal ‘SeGeopa anaes Anon ON apne None Bes Zi ah itty taste ee i oon? ester ate 0 Fete Dawei p90 i oe [bech cop e ste otr er oi t] arent BB 14812. rtpn eerie roy oe vgn teeny yer carn Ep br pron at rca ete OS ‘Whose a ane pr bro eeaipae be Fo Pet fens fon a aa BT son i ‘Seto 3, PRIOR EME. OVMENT WIT! OTHER GMERS EMPLOYERS enous od rarer emplyer tata mente f ES yor ue ge? ove ge 9s sowed Mi pw tid EDS cp ae ee ee ‘Sectun 4. EMPLOYEE ACKNOWLEDGMENT ‘nett seen mentite ese ea ‘ey egy fbn eae reeme prt he a af ty ee wae e an, wil Eaminy borcnanroarterinane erases vue 06 yal 12 ‘wean — ay ea Ennio Seat ‘Seto, PENSION COMMITTEE REVIEW & ACCEPTANCE ee pints ea by me, 28th gad ye at TSS al ad arenas. ae rama — COMERS Fom gL WieCappCMENS —YebowComEmponr Pak ConnorMUNICIPAL ASSOCIATION ‘Suu 1 EMPLOYEE. INFORMATION moves nase Zecbarah, a. ae ‘easy pbs an moran Singshad Police Departnost ‘Sect, PRIMARY RENESICLARY. BENET CIY ce ptonpe a ety tho pylon yt er ft set be tm oe cts y Enpe heme Pa ace © aden CEO ‘Misa ime Bonen ES) Py et Sa ae RE 129 ic i Coe: OMe Ae tao ey Bey A nereeneen ra) a) apes) ‘Sen 3 SECONDARY BENPEICIARY {ey deat he tiie sand pense (ONLY ONE PERSON MAY BE DESIGNATED) os xy SECO eninge) BENEFICIARY. ee vera des ty th mbps fy tn by ured FRBNY BENEFICARY esse ee ra [owt fly girs Reem Pn snd be Coad Brat Be, Syn Ey Set et nc no a a | ee eke: stented ell ee ee = . ‘Sison 4, EMPLOVES SIGNATURE | ty ote ove bmn eed at Des fy elt I ted ove ‘siping eens ‘ee rat nee ttre meer sea io Comme Scary enti cg foe er anand oye mae et ‘tiny deiaon a sng, sl ae etn a il ae pede ol ‘em ieccsounes | Dassignt Of o 212. ‘aes — ty ee att eo i ono WELT ‘Ses, RECEIPT RY PEASION COMMITTEE SECRETARY, eS eT COMERS WANES Yeon caeCity of Kingsland, Georgia or ae a Hone Prove: UGMEMNNNN ——_Atomate Phone: D 5: TT ane ee soca Sect eer Come Spouse's npc: SAR So.5's Work Pre: “Te _ Employee 10: = Supanisor ‘eparment ‘Werk Location: mal Ades: Work Prove cet Prone; {op Stan Date: Satay 8 Adress: o Sa Primary Prone: UMS Altemate Phone: _¢ _) Reto: ST‘STATE OF GEORGIA EMPLOYEE'S WITHHOLDING ALLOWANCE CERTIFICATE Ta YOUR FULL WANE 7B, YOUR SOCAL SECURITY NUNBER. Zechwrik, Mark fretly ante Soa, a ara Raa) Be (0 DP CODE 5 EAS RTE RETEST = {. MARITAL STATUS 0 {Aare Fig ict oe poise wong 6 ADOMONAL ALLOWANCES a Enerdor ter? ‘wortcheet below mtb complied) atte Fing Sper EnrOort oo Hondo Husa {6 ADDONAL WITHHOLDING Emer ert ‘WORKSHEET FOR CALCULATING ADDITIONAL ALLOWANCES (ust bo comploted In order to ntor an amount on atop 6) 4. COMPLETE THIS LINE ONLY If USING STANDARD DEDUCTION: Yourselt 1 Ago8 orover Bind Spouse: C1 Ages orover [Bind Number of boxes checked _x 1800. [ADDITIONAL ALLOWANCES FOR DEDUCTIONS: Fedora! Estimated Homz0d Deductont cnn se (Georgia Standard Deduction (enter one): SinglaMead of Household $2,900, Each Spouse 31.500 8 Sublet Line B fom Line Ae ‘Atowabie Deductions to Federal Austd Gros Income ‘Ad tho Amounts on Lines 1,20, 84 20 nnn etato of Taxable Income not Subject to Winokdng Subiract Line F fom Line & (zero or less, stop her). Divide the Amount on Line G by $3,000. Entor iota here and on Lin 8 above... (ithe maximum number of adel atowances you can can. th rade is ver 1,500 ound wp) BPe zemmoe 7. LETTER USED Marta! Sats A 8,0, o<) Gil ‘TOTAL ALLOWANCES (Teta Los 3-6) SB The er natn a aio rippers Tau = (Do nol completo Lines 3-7 calming @xOnp ead ha Used inavcions on pape Tonos compntng Bi seca 1} cam emen fom wicking becouse ncured ra Gerla nena ax aby tt yas and onl expect fave a Georgia come tax aby ts yor. check hore 1) eat mat am ot ute © Georgi winking bacaoe meat ho conons st et under te Servcamambers ‘Ch Ratet Act os emendod by to tary Spouses Resoncy Rett Ac ax prowsod on pogo 2. My eats of eatsoca —____ ty spouses eervcorobey st of restene “me aan reise imastbo ho sanats be amngt Chock hore Cl Teena, peat ofp fon erage aro tlemod on Gis Form G4 Als, Lauerze my omployr te Godt per ey parodia ado! amout lod Dove. ‘De not accept forms cling sddtona!atowances unas the worksheet has boon completed Do not accept forme ‘leming exempt f numbers are weition on Lins 3-7, =1) Check the it bx fy gay to clam exempt fom witoling, You can clin exemp if you fled ecg ncome te ‘etm ht yearend the amount Lin 4 of For S00EZor Line 1 of orm 300 wes ar, ad you expect flea Georgia {sc reum ls eran wil ot ae tx abil. You ot aim exempt you di wt fla Georg income ex eum {rte previous tx yr. Raclvng a efund i the previous tax yar don bet guaif You team expt EXAMPLES: Your enployer wield 300 of Georgi income tx fom you wages. The mont on Lin 4 of Form S052. (Gr Line 1 of Form 50) wes $100. Your tn laby& the moat on Line (or Lie 16 thei, you do oat qual © 2 Ike mse of seviemanter is nied th proton ofthe Mitr Spouses Residency Rell Actin nthe stunt lea wing exemption frm in sh oer ste, the spouse requred ub a Geowgia Form Gt Se hat wit wl ooar as regued by Georg Law when» Geog comin we n moe sae end ‘wild ot ued by uch ter ate. Ite spouse oe ot fil ot he om, he employer hl wield ‘Georgi icone tx site moses single with 2 lowers, ‘Werkabeet for eaalang odio allowances. Enter informaion a requested by cch oe. Fot Line 2, et ten sich ‘5 Retenent come Exchsin, US. Obptony and oe lone dedoton pe Goria Law, se the Ti boot or ‘Dose complete Lines 37 dag exempt OC... § 487-102 resin you a complete end shi Form Go your employer inode to ve tx wt fe your ‘wages, By comely compleing tis frm Jou cna bs umount of tx with! oma your tnt Ly. Fala sa ‘ope complaed For O-t will aus our employer wining xe ugh ou se se wi re alowanssForm W4 (2047) Saeco Eaters Seeaeeees es Se area ee Pecmeeletesias ene [ SE Nepean j eigenen necasiagetetinn orem (© Erte“ for jour spouso, Sut ou may choose fener“. youare marie anahave eter a wang spews or mare ‘per oneon Erg “0 may hep you ra hang oe tx wets) 1D _Erernunberf dependents ter than your spouse or oul you wileltin on your tx lun & yu Wf as hoa of Reveholon your tae oe condtons naar esd of househol shee) F tyouhae east $200 of chil or depandent cae expenses fo which youpian 6 ia (Mote: Do notin asic payments See Pu. 5, Ci and Dependant Cae Expres fr eta) (2 Gna Tax Crt (rctaingetonl rc cra.So Pub O72, Chi Tox Cre oem, * yourtots ca wt ees han $700 (100000 rare) oar" each lg chi anos “Hou ave oer tg con aloes" i youve fv crate sgl ctr. 1 journey 7000 a $8400 0000 en HCOOH mare ne “Ioreacheigioci. 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However ura tng ty noe fo ea ar SD eo et ee rome = een ntenenentnnene 2 {nw fa mor han or og fra 2 ett ne 2 or 1 Ex th rut hare 2, rer a") anon Ferm Whe, pga Do not ashe se ls werkt. Note HE ston tno 2 ear” on Fom Ws re 8 G8. Complete ies 4 gh blow ‘tg eon! woking eat nanos wai a Yura wx ture umbarfomino Zt iaweeahest s+ ‘ norte onbarfonine teftiawedabest LL 5 SwmectinStominad. vn ne Fe tha ean Tebo2 below ht spp toe HOHEST payig ob andere Rha ‘uty nw 7 yin sede theresa. Til to atonal arr wot ned = iN ‘ 6 I Ng; a Lit Se anne a, Sepaiciienmeteaiterusttosems toes steeds Su Sarparascteeescsaeany aneimepay nT” ied trgts as cos ney ans eal Swenson re etn boone none Spee ieeanteseemey tern na toaEmployee Direct Deposit Enrollment Form on int gst, snl hom ai your pel deck otha en Ath lh cing a rst Meningie yr a eyo ase Kanes unset hats be ac tte on a (Sfnts. Trp ema jus ty Beil ek ICR ding we nn yc ifn es ie 14 O323usu 781+ aeausk7ede. Dioy Genie Roatan rrr) Gas aSSpecum tay (Diem mae ain Sinem ogemcemrracoe IMPORTANT! Plese read and sign before completing {ue sutra he yo ant we ay tas oe ‘25 Por nrc Du men eye eel Cay fgg aetna eye ang ss ‘edhe soa sea auc Giy of asty a eran ana ee ep na othe eer Th sbi ol es te Cy af andl Dkr seed wie son stn ec ied ch TRicraiatow eC aeplednd tt um pound aan Employee None Zechorcl, fy Sci $y LS Employee Signaure Zed d FE- = Date: 6 -/- 17. st iy athe nel ata rete“) eon ‘Account Information “The lst em must be forthe remaining amount owed 19 you, To disrbute to more account, please complete anther form. [Make sure indicate what tobe deposited less than your total met paycheck, 1. Bank Name/Ciy/State: 1 1 TT Ne Checking Savings other I wish to deposit: or Entire Net Amount of account along 2. Bank NamelCity State: Routing Transits COchesking Savings Other wish a deposit 5 or Cte Net Amount _—Aecount Number: 3, Bank NameCityState Routing Transits “Account Number Clewecking Savings Other I wish o depot: § or Dente Net Amount ATTENTION {Employers must kep ech erga employe enrall yeas threaten. at form on file at longa he employe sing Diret Deposit and for woLISTS OF ACCEPTABLE DOCUMENTS ‘All documents must be UNEXPIRED. Employees may present one selection fom List A ‘a combination of ene selection Wor Lis B and one selection rom ist. usta usta uste Documents that stash (| Cocament tht Estab Documents that stich Sotnidenty and dant Employment huthorzaon Employment Authoration BR a0 f. Us.Pemotos Pempotcus | [- Dewaionm aw Dmgmnaiye | 1. Alea net Amano, Shocrccywemanionstte’" |" Gagunate eco ronson Femara Cava |-| Uamdsunesoscestcotares | ebiwig aon — [| proteaaph inert sch 8 (1) NOTVALD FOR EMPLOYMENT 3. Foreign passport contains 8 ‘eporar 51 amp etary "581 primed notation ena maine readebe immigrant vis a Enploymant Adboteaion Dooimert {tateomain a photograph Fom (@ VAUD FOR WORK ONLY WT INS AUTHORZAMON Jt Weard ime by eset tw eress!| —) vaLio FOR WORKONLY WITH ‘goverment agence or eis, DAS AUTHORIZATION ‘Eomaton sch a rao, ate often & Csi of ih Area aod ‘ender hegh eye cla, and ares | Dj De Deparment of Site For re) Poses). Behold wih a proogaph Fora prinmaret ion sahatznd Gotten of Repo of Bh tower aspecc empire "Yatra regeaton cars ‘suns ye Coperment St ecaue ois re tas (Fam 08-r360, 1. Foreign passport and 1 For 04 o Form 04 that has tha following: US. Coest Guard Merchant Mariner a nae oe (Tg same name same pasipor} | ce bang sn ofl sol Native Arern wow cocorent [6 Nate scone (@)Anendorcement fhe ars = i a ‘onmmigrni stats aera as || Divers ceo sevedby @Canatan [6 ys cazen 10 Cad (Fom 17 ‘hat pered ofenceremanthat |, | _govemmat aubriy ea ‘ote expe and he i 7 entation Card Use of [oposod ampioymentis natin || For persons under age 18 who are | ”” Restart cizenin the Unaed oumcwihanyrecretorsr | | unableto presenta document | State (Fom 179), Etats ented oni form | Usted above: | Employment automaton & casper te Fede Stet | a eanaraantorepatord onment sued bye sia FSM) or he Repl rte Homeland Socurty the Mare ards (wan Frm |, Cine Gor Psst nod Severe Ser Fom r90hiesatng [ nonimmigrant arisen unéerbe |. [32 Daycare ornare stool ord ol ree Assoition Between (Boni Ste andthe FSM orl | Examples of many of these documents appear In Part 8 of the Handbook for Employers (M-274). Refer tothe instructions for more information about acceptable receipts. Fame TAROI6N PagersAffidavit Verifying Status for City of Kingsland Public Benefit By executing ths affidavit under outh, as an applicant fora City of Kingsland, Georgia public benefit as referenced in 0.C.G.A. Section 50-36-1, lam stating the following with respect to my application for a City of Kingsland, Georgia, public benefit for {insert name). 1) am Unie Sates Caen on 2) __T am lel peerunent resent 18 years of age oor or 1am an othervise ‘pale alien ornotramgynt under the Fede Immigration and Netonaiy Act 18 Yours ge older and awl preset inthe United States. © ln making the sbove representation under th I unertand thet ay pron who knowingly and willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall be guilty of violation of Code Section 16-10-20 ofthe Official Code of Georgia. S112 ‘oF Applicant Date Zeccherise_froky Printed Name SUBSCRIBED AND SWORN * ———— [BEFORE ME ON THIS THE Alien Registration Number for Non-Citizens [PF oav or Dine: 20 11 My Commission ‘Note: O.C.G.A. §50-36-1()@2) requires that aliens under the Federal Immigration and ‘Nationality Act, Tite 8 U.S.C. as amended, provide their alien registration number. Because legal permanent residents are included in the federal definition of "alien, legal permanent residents, ‘ust also provide their alien registration number. Qualified aliens that do not have an alien registration number may supply another identifying numberPOST OFFER OF EMPLOYMENT MEDICAL INQUIRY Responses to there question are completly confdenil and wil be ited only I necter to determine ay reasonable accommodations equed fr any work you may perarm whater any health conden may poses dec treat of airy 0 ours or thers, toast wth treatment of ny werkelted jury, ofr any other lawful purpose. ame Zechwrid Presi Department: Kingsland Poston: fol offer Tothebes of your mowedge do youhaveorhaveyouhad any of he following edi condtons? (For "ye" responses, nets the nature fury o tines and name of physian nthe remars section) asus YES oro: —+ totepsy 2. Diabetes So artis ee amputated oot. arm ‘orhand 5 Lasef sight of one or both ‘eyes ors pra os of sight esta bit frm Pohmalis 2. carer pay oie rote 9. Parkinson's deeace 30. Cadlovarcdar orders 2. Tubereuons ental asabty folowing confinement for ‘resonant in arecopnined ‘medial or mental instion| fora prod in exes of sx monte 33, Hemophtia 1, Sila cel anemia 5s cron steamers it stoner mt ne 27, Manele dys 0phy 8 Neatng oe 18. compressed a soquels Ze: seater nur or probions ar tack eonaions ident below) tacky back pln which requred medal estmert e backsuey . daganernive dsc disease Te mull back strains Tie erenibek pan Te. herniated de 22, Neckcondton dentty below) a neck lay Tle neck pin which roqured ‘redial reatment eck ree egeneratve dsc dense mule neck trains ‘oni eck ein hemited ase a lefelnee gery Toe ightinee surgery Te other (en) 28 Hireplacerent surgery 25: setng of any ent which quired ‘medial eatment 26, Hema Carpal Tunnel Syndrome 28. Sager (epin) tevats Thal a _sty asa chil ja He ye too, Et crm te (ie sal Zin Fad fp Probl Sanye 9 1 Zeus fist _femloen, stax hth sbovefomatins rue and compete th best of my knowledge Sone trons oe GP —_ of 112 Sgptureoftmployer—_ at,Georgia Municipal Employees Benefit System Affidavit Verifying Applicant's Lawful Immigration Status ‘As Applet oben snide Goa Manic Eaplyes elt yen (MEDS) Ipriat Applet Ps ladle and Lax ame ero]: Zestargh Pua Pasty nn ‘state the following under oath [check (1), (2) or (3) below]: 7 tama United stats citizen @ ‘Tama legal permanent resident ofthe United States ® 1am a qualifed alien or non-immigant under the Federal Immigntion and [Nationality Act with an alien number issued by the Deparment of Homeland ‘Security or oer federal immigration ageney. My alien registration number® issued by the Department of Homeland Secuiy or other federal immigration agency is also hereby verify that Iam 18 years of age or older and have provided at least one secure and verfible document, as required by O.C.G.A. §50-36-1(0)(1, wit his affidavit. The secure and verifiable document provided with this efidevit can best be classified as: understand thu this affidavit is not comple until Ihave provided such dooumentation, In making th shove representation under oath, I understand that any person who Imowingly and willfly makes a fhlse, fstous, of fraudulent statement o representation in an affidavit shall be guilty of a violation of O.CGA. § 16-10-20, and face criminal penalties as allowed by such criminal statute Bxecwed ia_Kingsland (iy), Genrgia__(sats). 6-4. 12 Sepia at Bia Bay Vea —— . : } | Ach ‘aR aber Epp lee pad ssc AND 5 SERORE MEON TAS Nosy Pe sea ne “Note: OCA. §50:361(0(2) rogue or non-immigrant under the fora Immigeucn aad Natioeality Ac, Tile 8 ‘USC, wands rove roe mp ber fou ae sq sen at yo dant bem sen egnon sabe, You ate to GMEDG Member Emplyr: Ths applet wl ot be deemed complete ula «copy of the Applcn’sseure end ‘ets dunt or proved sd pasted ye Ataray Genera parent o GCA § 30-95) amare or aaCity of Kingsland, Georgia ACKNOWLEDGMENT OF RECEIPT OF EMPLOYEE HANDBOOK. ‘The Employee Handbook contains important information about the City, and T understand that I should consul the Human Resourees Manager regarding any questions not answered in the handbook. have entered into my employment relationship withthe Cty of Kingsland voluntarily and understand that there is no specified length of employment. Accordingly, ether the City or Tn terminate the relationship at will at any time, with or without cause, and with or without sévance notice. T understand and agre that no person may enter into an employment agreement for any specified period of ime, or make any agreement contrary tothe Citys stated employment-at-will policy. Since the information, polices, and benefits described herein are subject to change at any time, I tcknowledge that revisions to the handbook may oocur, except to the City’s policy of employment-a-will, All such changes will generally be communicated through official notices, and [understand that revised information may supersede, modify or eliminate existing policies. Only the Mayor and City Council has the ability to adopt any revisions to the polices in this handbook, Furthermore, understand that this handbook is neither a contract of employment no a legally binding tgreement. I have had an opportunity to read the handbook, and I understand that I may ask my supervisor of any employee of the Human Resources Department any questions I might have concerning the handbook. I accept the terms of the handbook. I also understand tht it is my responsibilty to comply with the policies contained in this handbook, and any revisions made tit. 1 ‘ther agree tha iT remain withthe City following any modifications tothe handbook, I thereby accept and agree to such changes. have received a copy ofthe City of Kingsland’s Employee Handbook on the date listed below. 1 ‘understand that I am expected to read the entire handbook. Additionally, 1 will sign this Acknowledgment of Receipt and I understand that ths form wil be retained in my persone! file.City of Kingsland, Georgia EMPLOYEE SAFETY MANUAL RECEIPT ACKNOWLEDGMENT (Lane to bestgned by emplyee once be has recived the employes safety manuel and understands is efecd I have received my copy of the City of Kingsland Safety Policy Manual, It is my responsibility to read and understand the matters set forth in this Manual. It is a guide to City’s safety policies and procedures. T understand and acknowledge that the City has the right, without prior notice, to modify, amend or terminate policies, practices, benefit plans, and other institutional programs within the limits and requirements imposed by law. Signeds ya Return signed form to Human ResourcesCity of Kingsland, Georgia Probation Acknowledgement 1, Zederal, Aw Preity, understand that a newly hired employee of the City of Kingsland, Georgia, I willbe working in a probationary period of twelve (12) months, beginning on the date that I bepin my employment. The terms ofthis probation are that I willbe subject to immediate dismissal should it becomeCity of Kingsland Post Offs Box 250, Kingsland, Georgia 31586 BoINT63 = ODS ACKNOWLEDGMENT. Thave received a copy ofthe Job Description and have read and understand its contents Zechoryh Presley fae nl aa ae pleue2 EZ _- on Employee Sigiatare Date “Supervisor's Signature DateNotice of Workers’ Compensation Procedures ‘This is to certify that | have read and understand the Workers’ Compensation PANEL OF PHYSICIANS notice. | understand that when | am involved in an on-the ob injury my employer wil pay medical costs for treatment by the physicians) | select from the Panel of Physicians. If | desire to obtain medical services from a physician not listed on the Panel, i may do so: however, | wil be lable for those medical expenses. The physiclan’selected from the Panel of Physicians may arrange for appropriate ‘consultations, referrals, and other specialized medical services as the nature of the injury requires. if | am dissatisfied with the physician selected, | may make cone change without permission to a second physician also listed on the Panel. Upon notification of the employer or its administrator, an Independent Medical Examination may be elected as set forth by the law. However, any further changes require the permission of the employer/insurer, setfnsurer claims fice, or the State Board of Workers’ Compensation. In the case of a bona-fide emergency involving severe injury or when a Panel of Physicians is not available, | should seek medical care from the nearest Hospital Emergency Room. However, all folow-up care must, thereafter, be rendered by ‘a physician from the Panel, or a Panel Physician’s referral. | further understand that | must notify my immediate supervisor or a member of the departments administrative staff or the Human Resources Department a3. ‘s00n the injury occurs, regardless of the extent of the injury, and when possible prior to seeking treatment. | understand that the treating physician will verify my ‘employment and eligibility for treatment with my employer before commencing treatment unless the nature of the injury so prohibits. Delay in notification may result in denial of payment for medical services rendered. Zecarigl, _tiesley Er ‘lease print name) Social Security # Signature of Employes) Date ‘Gignature of Witness) Date| CASTLEBRANCH © RESULTS SUMMARY | eewcessttencenen.com SS) ee Company Name: CITY OF KINGSLAND Order Date: 057902017 = ‘Company ID: 1G41 dor TT as First Name: ZECHARIAH Date of Birth (008) SBPI091 ) Middle Name: M Social Security Number ($N): soca stent rt PRESLEY ZEST 3 SUED ens Wat PRESLEY ESHA rast SSE inna meer sats ae sia rary te TREE EOTRINT oe Saree ‘Sere acs at enters earn dat See atleast uri fas ma us rare tyes at rgnatone eng ry ‘eiSee pm cai ot) sisaeCASTLEBRANCH © ‘STATEWIDE CRIMINAL RESULTS Company: CITY OF KINGSLAND Oe Item Date: 05/90/2017 ‘Name: ZECHARIAH M PRESLEY Date of Birth (O08) ammmR'991 Social Security Number (SSN) Location: US - GEORGIA ‘CASE MUNBER 201774632 1S A CONFIRMED HATCH, [es Secton ‘Name. fet PRESLEY, ZECHARIAN MARK 108 ene: ames ‘SEN on fe: = ‘eden on te NONE REPORTED. oy: NONE REPORTED. Stat: NONE REPORTED. (uring NONE REPORTED. 2p NONE REPORTED. ‘eros Vess By: NOME REPORTED. ‘vers sence Number NONE REPORTED. ral Intron Repoted ott CAUDEN, GA Cave Number zorrTaese Case Sau DisPosED [Eimaaettorntion ‘count 7 Lvl of Crags: MSOEMEANOR Charge: FLEENG OR ATTEMPTING TO ELUDE A POLICE OFFICER. Pree [NONE REPORTED. Vert DistesseD Lvl of Canton NONE REPORTED. ones a NONE REPORTED. ‘Sentance: NONE REPORTED. Offense Date sooner Talat: NONE REPORTED. iposion Oat cuneate ‘STATE IDENTIFGATION NUMBER: GAAOSO20X‘sures hav minum scp 7 yan reas eerise ee. Teprsscing eco ay Dango ba nun unto, Ase ‘Snir clu a cons combat a stwing. woe vue paring tare eat ta, a bith aon Sx oo ond ‘Seal vty ar, rn ects gnuray de al nao cl serty ror h ea. Cas Orn mine oc pene ‘Sttace reborn quoston ts paso lb recta veces So ep oh a sion rch “peeing ncn at arent ban of ea ene Fr ans coy OaCASTLEBRANC! © ‘SOCIAL SECURITY ALERT RESULTS ‘Company: CITY OF KINGSLAND Order em tem Date: 05/30/2017 Name: ZECHARIAH M PRESLEY Date of Birth (DOB): 1991 ‘Soclal Security Number (SSN) iow Location: US - NATIONWIDE oie internation iy Aart ‘Bond ona search of ple and palo dlaboos ha along amaton assed wih prod soda secuy rumor ‘name infomation ate obi infomation Epunwiumes.cy mo: ZECHARIAH M PRESLEY ra ZECHARIAH M PRESLEY ra “Tho cy way vert a Sokal Socury Number tough the Sock SocutyAdminsaon (SSA) The SSA coast alow ‘ir pates, ning employment seein compares, very Sell Sezity Nenbes, Vefaon ofa Socal Secrty ‘umber can ba doo ob employer and only ater Py hae xenGed a ob taro an inva. To eran soy ‘Social Secuy Nabe, cal 1800-72 270 Phase hav he erpoyer's nano as Lappare one Sell Soc ead De (ft Sox and our compan Feral EN numba rosy to xpedio his roses. ‘cl soy umber rma esas gry onto nani ston Asstt aiovea congue Preparing ce reso ran, ty ner ast Cost ‘Sninaso ar bongt he mca ution Wino ta ne procs rcrs Son spy there sta Cate Saneh ‘Sper at ganzatane stp ary cama ara recrn ae ator ne wl gotten, Fr quan creo ee ‘eee pest o15S008CASTLEBRANCH RESIDENCY HISTORY RESULTS wes.castiehraveh.tom Company. CITY OF KINGSLAND ores item Date: 08/002017 Date of Birth (C8 Nm 231 Social Security Number (SSF ) Name: ZECHARIAH_M_PRESLEY Location: US - NATIONWIDE Alicant Provided itormation ees Wit ame acess ‘dates ZECHARIAH M PRESLEY ert2019 To oars ZECHARIAH PRESLEY ‘Sanezote Toosnage17 ZECHARIAH M PRESLEY onazot0 To o4gan0tt ‘ZEGHARIONLM PRESLEY xzcts 0 ostz0t7 ZECHARIAH M PRESLEY ‘rowzpt2 To uanazos oak 2 PRESLEY rowaota Touaraao's ‘tis goesie or ames, acdressen andor dts be fepated at ar ot atmalely cerned oe entfos sbi batearch.nacitateniermaionc Npienly envead by eels ony err in a eel ea sto Mthe pas. ‘haem aman no? reso ro Te poco abe wh bi ni Aue ‘ca sei rater ral ed uray ont nce = sas eect ranour hes east ‘aa race bang fs usin Mp hat he aoe cr Som sy Salman nn oy cial srr ore ote nam sn Fo san ean BaeZechariah M Presley MELEE ‘Background check results from Castle Branch, Inc. ae available olin at ww. CasteBranch.com. To view resus for the applicant above, enter the Pas provide below in the "view backgraund check” box on the website. Indviul applicants may also review ther results using this information. Caste Branch backsround check results cantaina seal of certification and a unique password (ePass). As requested, background check results may be faxes, emalled or printed. Reviewing a backgrauns chek aiectly fom te Castle ‘Branch website provides a real-time lok at results. This assures tht the results are accurate and the applicant has not tampered with them, ePass ZNYLP3 date 06-01-2017 leas contact us with ny gu that you may have o your organization woul Ika moe infomation aout or sees Cwvmeastbranchcom Phone (888) 723-4263, ‘sntomerserice@easebranch comPara informacién en espafo, visite www.consumerfinance.gowlearnmoreo escribe ala Consumer Financlal Protection Bureau, 1700 G Sireet N.W., Washington, DC 20552. ‘A Summary of Your Rights Under the Fair Credit Reporting Act ‘The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, faimess, and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is @ ‘summary of your major rights under the FCRA. For more information, including information ‘about additional rights, go to www.consumerfinance.gov/learamore or write to: Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552, + You must be told i information in your file has been used against you. Anyone who uses & ‘credit report or another typeof consumer report to deny your application for credit, insurance, or ‘employment — orto take another adverse ation against you —must tell you, and must give you ‘the name, addres, and phone number ofthe agency that provided the information. + You have the right o know what i in your file, You may request and obtain all the {information about you in te files ofa consumer reporting agency (your “file disclosure"). You ‘wil be required to provide proper identification, which may include your Social Security number. In many cases, the disclosure willbe free. You ae entitled toa fre file disclosure ift “a person has taken adverse action against you because of information in your credit report; + you are the vietim of identify thet and place a fraud alert in your file; + your file contains inaccurate information asa result of fraud; + you are on public assistance; + you are unemployed but expect to apply for employment within 60 days. In addition, all consumers are entitled to one free disclosure every 12 months upon request from cach nationwide credit breau and from nationwide specialty consumer reporting agencies. See \wonw.consumerfinance gov/learamore for additional information. + You have the right o ask fora credit score. Credit scores are numerical summaries of your credit-worthness based on information from credit bureaus, You may request a credit score from consumer reporting agencies that create scores or distribute scores used in residential real ‘property loans, but you will have to pay for it. In some mortgage transactions, you will receive ‘credit score information for free ftom the mortgage lender. + You have the right to dispute incomplete or inaccurate information. Ifyou identify information in your file thats incomplete or inaccurate, and report it tothe consumer reporting agency, the agency must investigate unless your dispute is frivolous. See ‘wonw.consumerfinance-gov/learnmore for an explanation of dispute procedures. + Consumer reporting agencies must correct or delete inaccurate, incomplete, or ‘unverifiable information. Inaccurate, incomplete or unverifiable information must be removedor corrected usually within 30 days. However, a consumer reporting agency may continue to report information it has verified as accurate. + Consumer reporting agencies may not report outdated negative information. In most ‘cases, a consumer reporting agency may not report negative information that s more than seven years old, or bankruptcies that are more than 10 years old. + Access to your files limited. A consumer reporting agency may provide information about ‘you only to people with a valid need ~ usually o consider an application with a creditor, insurer, ‘employer, landlord, or other business. The FCRA specifies those with a valid need for access. + You must give your consent for reports tobe provided to employers. A consumer reporting agency may not give out information about you to your employer, ora potential employer, ‘without your written consent given tothe employer. Written consent generally is not required in the trucking industry. For more information, goto www.consumerfinance.gov/leammore. + You may limit “prescreened” offers of credit and insurance you get based on information {in your credit report. Unsolicited “prescreened” offers for credit and insurance must nelude a toll-free phone number you can call i you choose to remave your name and address from the lists these offers are based on. You may opt-out withthe nationwide credit bureaus at 1-888-567- 8688, + You may seek damages from violators. Ifa consumer reporting agency o, in some eases, a user of consumer reports ora furisher of information toa consunner reporting agency violates the FCRA, you may be able to sue in state or federal court. + Identity theft vietims and active duty military personnel have additional rights, For more ‘information, visit www. consumerfinance.gov"learnmore‘States may enforce the CRA, and many states have their own consumer reporting laws. In some cases, you may have more rights under state law. For more information, contact ur etate olen consumer protection agency or your sate Attorney General. Bor ‘information about your federal rights, contact: ‘TYPE OF BUSINESS: {12 Ba, sig ection and et urn wh it cst et ‘rr 0 ben enero. Suh tos pt wnt es, sky eccors, oF cet (Gio tbe out maaan bare 4. Cris Stet Bre Tnsptaton Boo (5 Cras Sut tPatr an Spr A 621 {sat Buoss stan Compares 7, Bota nd Dot 9, Fea! Lan ats, Fdut an Bar aston Fee Tomects ect arn ta Pocono anos 4, ton ance Conan rs Alber Gufs etnd FE gar fe oni cee opt how ra rte Cos Corman Resse = Cn GinsetrCITY OF KINGSLAND. Employee Performance Review EMPLOYEE INFORMATION ame Zech M reser room to 70 seoTite Pavel fer woun0x7 Depertment 10050 Sven Sor Rarceary Revew Peres U601/2017 t oyOLIO8 narines . Unseisocny —mrevenere 7 SHOCOTY —“slryges $= astet seo know a c x a treaty any x teary 3 a f& comes nitive a a x a ‘Communication Cooperation < a ms go coma 2etament neon ng a x a ver Rating (verze terns aber sb) 2.0 EVALUATION roomomcomens Gften. [2 mace Te paper iin thy oc “hey el y VERIFICATION OF REVIEW sg ths fam you cat at yo ave asad Os ese I etal wh you sire. Sigg fr ost ecessiy ‘este at ov oe wat Os von tmionsomns Derg” BE mS HF Oy EO Shaleen CN SON. Orange Avenue, Suite 415 = = pa ‘Frac 407-839-8882, fimocleylaw@gmailcom To whercortenoll: he Offic 2. Poste, Dale: December 2019 Gtetm' isp 40 on Sz/irclon,’ = ae el. penbie) to corrply Mood You on LAr fpr ooionetn od poe b\w Tnassey, § a ibe ™ ol oe! mz relotuotre viol fae enfament beret bem beet =f deen 2 preety onl = Lefaree ovforraey Deas my 4 pee om Ver Opprpncte ed on OD he ae Icon Bodcem, a] het pater vein Coe ee Safer; hab bet ServersCity of Ringstand oxo es 250 Kegan, Cag st a an February 6, 2018, Me. Zechariah M. Presley eat Mir, Presey ‘This letter follows my review of an incident that occured on January 24, 2018, and clarifies the actions recommended by Assistant Police Chief, Wayne Peeples. As a resuit of your actions as detailed in the distiplinary report and IA file, Assistant Chief Peeples has recommended 10 me that you be placed on disciplinary suspension without pay for a period of one (1) day. Other recommendations are documented in the ease file and will be explained in person. Based on the information made available to me, I am upholding the recommendation to suspend you without pay. I am also upholding the additional recommendations outlined inthe Chief letter to me. In order to adequately accommodate departmental staffing needs, your dates of suspension are to be determined by Major Peeples, please contact him to determine scheduling. You are expected to report forall other regularly scheduled work days. Also, please be advised of the following as stated in the City of Kingsland [Employee Handbook: “Disciplinary Action Appeals If an employee is the subject of a progressive disciplinary action, the employee is frst encouraged (0 dlseuss the aetion with your immediate supervisor andor Department Head. after such discussion, or tempted discussion, you feel the matter is unresolved, ‘you may inlate the appeal procede. All City employees, with the exception of probationary and temporary employees, have ‘the right 0 appeal disciplinary actions as outlined in te progressive disciplinary policy ‘above, fo the next level supervisor. Afler the Department Heed, the appeal should be direcied fo the Human Resources Director andior City Manager. Ifthe disciplinary ‘action Is overturned at any level, you may be granted back pay or be reinstated to your‘Previous position wth back pay. The Human Resources Director and/or City Manager is ‘the final decision authorty regarding the dsclplinary appeal proceeding. tis my sincere hope that you will use better judgment inthe future and that you ‘will be able to meet the ever increasing challenges and requirements of your postion with the City of Kingsland. Your position with the Kingsland Police Department is an {important one and through your commitment to the city end your future, and our commitment to service and standards of excellence, we are confident that your performance level will improve oa level that satisfies all expectations. We look forward {your continued growth and progress. Ifyou have any procedaral questions, or if futher clarification is required, please feel tee to contact me directly. Lee H. Spell, CHRM City ManagerCity of Kingsland, Georgia Warning Notice EO [Employee Nome: Zechariah Presley Date: 02-022018 Employee: 10-0763 sob Tle: Palce Officer Manage Patol Lt J Sonward Department: Police Deparment x FestWaming Cl Second Waring TD Fina varing CI (D Tarcinssateavig Eery—C] Absent Wissen at cy Potay Substanden work X__ Vielaion of Safoy Rulos __]._Rudeness to CustomerCowerkors Chapter § Sec. 6-60 Appespe safely procedures andor safety poly anclrpractces wi be X Ober _{alomed by a employees amen) Deserton of ieteton: See attached Supervisory Rovow Investigation Pian for improvement ‘wt be addressed by Major Peeples CConsequencos of Further nactons: Vibe addressed by aor Peeplas £8, sing ti form, you conf hat you undrtand te ifrmaten in the warning, You ago conf tht yeu and your manager have discussed the wang ana plan fr irprovarent.Siring ts fam doesnot necessary ia tat you See —S De Ze ony Lt, baie Sot g-3-18 vires Spek Vanpyes wcboanavarrg baer Da) ‘aeCity of Kingsland, Georgia Employee Warning Notice Employee Neme: Zechariah Presley Datei 02022018 Employee IO: 10-0763 Job We: Pelee Officer Manager Patrol Lt J, Seaward Department’ Police Department oe X Fret Waring Second Waring FralWaming anes (QTardinessiteavingEary —C)_Absantoism X_Vielaton of ity Poicy C1 Substandard Work Violation Salat Rules —«)_Rucenes fo CustomaeCowertars ‘Kngeans Poca Stancard Operting Procedures anual X Omer, _Chapi§ Sect llB-18 Onand OF Duy Deserpon tet See attached Supervisory Review Investigation Pan for inprovement Vit be addressed by Major Peeples Consequences of Further nfactons ‘wt be addressed by Major Peeples '2ysining thi fom, you en hat you understand tho information nthe warning. Yow leo contre thet you sd your ‘manager have sacuased te waning and» pan fer improvement Sgrng the frm does nt reeeesarly sete not YoU Sproat warig. 2-4 Vines Spates Wenge onda wary las 6)Kemath& Smith S. Derry Grits Chief of Police City of Kingsland Police Bepartment Post Office Box 165, Kingsland, Georgia 31548 (012) 729-6254 ‘Supervisory Review Investigation Investigation Summary Date: 30 Jan 2018 Number: SR 2018-01-00 ‘To: Deputy Chief M. Wayne Peeples From: Lt Richard Sapp ‘The referenced Supervieory Review Investigation (Officer Zachariah Presley) has been completed and the folowing is a brief ivestigative summary. ‘Alleged voltion(s: Kingsland Police Standard Operating Procedures Manual (1) Chapter § Sect. 8 ~ 18 On and Off Duty * Sustained ‘Conduct Engaging in conduct on or off-duty which adversely affects the morale or efcency of the Deparment, or has a tendency to destroy the confidence and respect ofthe pubic forthe Departments prohibited ‘The evidence supports the allegation of misconduct, Generally speaking the special cted Rule, Regulation, or General or Special Order was violated by the member. Investigating Supervisor: Llevenant Richard Sapp Reviewed By: Deputy Chief M. Wayne Peoples ‘Summary of events: ‘On January 27, 2018 at approximately §:15 p.m. | recelved a cal from Major Wayne Peeples in reference o an incident that Offcer Zachariah Presley had Just been involved in. Major Peeples {id not advise me of any detalis he just Instructed me to cal the on duty supervisor, Sergeant Greg Crews and have him give the information.Kenna Sith Se Dany crs Mayor Chief of Police City of Kingsland Police Department Post Ofie Box 1638, Kingsland, Georgia 31548 (912) 729-854 Supervisory Review Investigation vestigation Summary ‘At approximately 5:21 pm. | made contact with Sgt. Crewe, he stated that approximately 45, mites earlier Offcer Presley who was off duty in his prvae vehicle called in tothe 817 and advised them ofa reckless driver on highway 40 in the area of Dunkin Donuts, Sgt. Crews seid that Offcer Praslay bagan ta fellow the vehicle north bound an the intersiate from ext three at speeds in excess of 100 mph. Sgt Crews said he spoke with Officer Presley and advised him via telephone fo stop folowing the vehicle and explained to him thai ne was nat pacmitte by pokcy to periorm such action Sgt. Cres sald Offleer Presley stopped follaving the vehicle and stated ha cid know he wasc' allowed todo that. | asked Sgt. Crews if any ofcer made contact with tha vehicle and he stated no (On January 29,2018 Inspector Belcher and | met wth Offcer Presiay in Inspector Belchers offoe ‘and conductes an audio Yacorded intervisw (Officer Presley state that a vehicle was traveling behind him on highway 40 nearly rammed in to him tie. Fe Said the valet wae driving very reckless and changing lanes. Officer Preslay said he followed the vehicle and called the tag and descricton into fo 811 diepstch. Officer Presley ‘id he was trying 1 880 iho could get an officer to make contact, Officer Presley said when he ‘was flowing the vehicle on 1-95 noth bound he locked down and realized he was speeding in excess of 100 mh and backed off Ofcar Presley said he cd realize he was going so fast because ne was cxving 2 new eat and it drove £9 smooth. Officer Presley seid when Sat. Crews spoke vith him on ha phone he stopped following the vehice and now understands he should ret have done that and the re involved, Inspector Seicher and | spoke ith Officer Presley in lenath about the polies, procedures, and labity when an of duty offeer engages in such actvty. ‘This nveetigation summary wil be turned over to a supervisor review board for dlscussion and tne determination i disciplinary action is needed. Respectfully Submited, Bye. Z Lt Renard Sapp aipeaeIncident Report © Pint Daan: o¥920180829 nga Paes Deport LognDs ope ConInamberGACG00I00 nto rn 284 P eet Racket ——< owe at ad ‘ Seow i —— sen eee a 7 ea ss wat ee a rom) Sapa oa = : i = iost art oats. oR cAI. Poets ‘zante: leans tet Nereis CALLED BACK IN ‘Ouzrats: 164727 tet Nava: CALLED IN ON 911 ‘zane: Leos test Narratives STILL BERIND FT AT DUNIIN DONUTS IN THE DRIVETHRU ‘OLzan6 162659 ttt Narada: WME ‘L208: 162646 ttt Narrative: DRIVING TOO CLOSELY NOT USING TURN SIONALS CUTTING LANES. ‘Labs : 162690 tort Nara: GA 1028 CHPGITL GOLD ALTINA, (anaes 161 emut Narra: PULLING INTO DUNIGN DONUTS. (h/z1a018 e264 tet Nerratie: VEHIN FRONT OF HIM ALMOST CAUSED A FEW 10408Voluntary Statement Form vodeysome:_t/ 29 112. Case Number nme _SCoTT “SEEER EY Tas ‘i iy seis LS 24TH SEAR DARN st Xtwasvann ae zsup ‘Bee (site) (ip code) —— (ema, Pleceeftmployment: ae oor yea Dee’tense Number Sect ecurty Number tecaton orden: aem___yean__mare, mone, oto, rsurance Company, Poly Humber‘GPSTC online class Dealing with Mentally or Diminished Capacity (hr. by February 28, 2018 2. Take GPSTC online class Transporting Prisoners (1 hr.) by February 28, 2018 3. Review with Patrol Supervisor SOP Chapter 8-1 (Taking suspects into Custody) 4, B days off without pay (Ofc. Prasiev: 1, Take GPSTC online class Dealing with Mentally lil or Diminished Capacity (ahr) by February 28, 2018 2. Take GPSTC online class Transporting Prisoners (1 hr.) by February 28, 2018 3. Review with Patrol Supervisor SOP Chapter 8-1 (Taking suspects Into Custody) 4. Extend probationary status an additional six months 5. 1 day off without payCITY OF KINGSLAND @® Employ Peromance Review ENPLOYEEINFORMATION s nore Zanwn heey Enpaee 75 ere poor we osovan oenet 050 onan Se amare even Pare 0501/2017 to 3/1/2017 Pbatenary Reve 1 of3 Fast Due RATINGS stot deb rowledge z ones woo inty a x camer steneane/ Pony a o mx 5 o nie etvey a z coms cemminction competion A o x 2udgmet/Oecion Maing fs mR vert Rating (nage te ag mutes ane) EVALUATION reomauiconens fps Prealay io preywrnr nll. (ibazeet oon by ‘ree on sur) ‘VERIFICATION OF REVIEW 1 sg ofa, you cot ta you ave cused ese ntl wh you sipersa. Siig fam Obes et necessny ‘ate a you ape a Os eration © emsoye satire owe 2/13 AE seersomie 74 Oy Pap om 2)ielisCITY OF KINGSLAND Employee Performance Review [EMPLOYEE INFORMATION ame 2ecarsh eey rojee 10.760 zn Tee pave Oteer Hee ogo017 beste 10050 soowe Sor Repeeay RetenPer O2017 2b Revew 23 Pas Doe narinss slsaany renee 2 SSH6300 Sob Knowledge o z & comments Work Quay! antiy a “& a comets -Attendance/ Punctuality x oiatvecreativey a x ‘communication Cooperation a x omens Delorean Haig a w a 5 cnmes ers To Compe Reamet uf or SOP Covert Rating vag te ag rumba sore) aE scorona.conmenns. Cffscan peer gers To Berm im Der Pon eA en off, BEL inches im Seen Ge, The gonke 32 conan ath Bin dagursnm sf Jes REET 2, come. ho pele piel iv god Teco sg fe ce a you oe cd ro nh Sy rm ty does Sastre NE semarsonne QA Cy hf om alleCity of Kingsland betective Name: Ziceula Beesey EMPLOYEE CHANGE OF STATUS ed Effective Date of Change: _S2P7°29,2o/7 pent, Bere vou: 7-7/7 “Type of Change Personal Information Remarks 1B Now Hire (see remarks) Re-Hire (see remarks) 1 Transfer (see remarks) 1a Termination - Reason (see remarks) Eligible for e-hire: Yes No Rate Increase: New Rate: S © Change of Address/Phone # © Part time to Full time 1 Full time to Pat time © Request for FMLA/LOA. 1 Tax Withholdings change surance ‘O New Enrollment 1B. Change in existing policy Dental ‘a Employee Only 1o Employee & Spouse Employee & Chilren a Family Effetive Date Medical ‘2 Employee Only a Employee & Spouse Employee & Children Address: ome Phone: — DoB: AC Full time. Part time Hourly Rate: $ Salary Rate: $ ‘Tax Information New Hire 2 Change for existing employee Federal Filing Status: # of Exemptions: Single O Married Q Marriedigher Single Rate State Filing Status: # of Exemptions Single Married joint - 1 working Married joint -2 working Married filing Separate Head of Household a a a a Tar Pepsin easKenneth ©. Smith, Sr. Mayor Daryl G. Griffis Chief of Police City of Kingsland Police Department Post Office Box 250, Kingsland, Georgia 31548 (912) 729-8254 APPLICATION FOR APPROVAL OF OFF-DUTY EMPLOYMENT (Part |) (To be completed by employee) 1. Employee's Nome: Zecharia Pesky 2, Present Assignment;_ Patrol 3. Prospective Off-Duty Employer ™den. Cosnly eanspertarin (Bus Driver) 4. Address: 6. Type of Business:_Govd. 6. Prospective Immediate Supervisor: Via 7. Business Phone: 8 Work Detail From: _ #7 Work Detail To: AA 9. Employment Duties: Zransurding 54 Prank fim schol an Felndeh activiter. 10. Will the employee be required to work more than 48 hours in a 14-day period? Yes No Friday, March 02, 2018 11" 12 13. 14. 18. 16. 17. 18. Will the employee be expected to wear the Kingstand Police Department uniform? Yes “No |Wilt the employee be required to use any Kingsland Police Department ‘equipment? ve io ‘Will the employee be expected to use police powers of arrest? Yes No Wit! the employee be involved in the collection of funds or repossession of va me ay ere yes no Wit! the employer be covered by the outside offuty employer's lability ‘Insurance policy? Live ne ill the employee be covered by the outside off-duty employer's workers’ ‘compensation Insurance policy? Aves No Does the employer selfalcoholic beverages to be consumed on promises? Yes No Friday, March 02, 2018 -2-APPLICATION FOR APPROVAL OF OFF-DUTY EMPLOYMENT (Part I!) (To be completed by employee) Leahy hereby make this request for ‘off-duty employment. | eerily that the Information contained in ‘my application is true and correct. | cerify that | have read Kingsland Police Department S.0.P. Chapter 5 (Departmental Personnel Policies), Section Ill (Rules and Regulations), Part D (Outside Employment) in its entirety. | certify that | wil, ‘abide by all fis terms and conditions, and that it will not confct with my oath of office {8a peace officer of the State of Georgia or the Cty of Kingsland., and that | will not be Working more than 48 hours in my outside off-duty job during any “4-day period. | fully understand that pursuant to the Kingsland Police Department policy, | wil not be ‘granted injury leave with pay i| become injured while on this off-duty employment. Iwill ‘advise my prospective employer ofthis policy and his/her potential responsibilty if should receive an incapactating injury; however, I do understand that | may use any sick leave | have accrued if become physically incapable of reporting for duty due to an of- duty injury, | fully understand tha in working at an outside off duty employment postion, | will not be working for the City of Kingsland or its Police Department and that my time spent in ‘outside off-duty employment will nt be counted toward accrual of any overtime pay or other benefits from the Kingsland Police Department. | fully understand that nothing contained in this request will affect my obligation to the Kingsiand Police Department to be available for emergency service; and I wil not accept this employment or any other employment without the express written consent of the City Manager or hisher designee. | understand thatthe City of Kingsland will not be responsible to any person for an injury that | cause wile performing my outside off-duty job, and that my outside offduty employer willbe solely responsible for such injury | fully understand thatthe City Manager, or his/her designee, is not obligated to approve ‘my outside off-duty employment and that he/she may deny or withdraw his her approval of my outside off-duty employment at any time and for any reason helshe deems ‘appropriate including for the corwenience of the Kingsland Police Department. E383 ye piyes Sinataeoate NOTE: DEPARTMENT EMPLOYEES ARE NOT PERMITTED TO WORK MORE THAN 48 HOURS OF OFF-DUTYIREGULAR OFF-DUTY EMPLOYMENT DURING ANY ONE PAY PERIOD (14 DAYS) Date Requested: 9- 3-/P Friday, March 02,2018 a3e‘Supervisor Signature: halon Conmende Signature Oy KA 3 hisls iy Marager (or deSgne8) Anprovel Ns ‘pproval Date ‘Disapproval Date Friday, March 02, 2018 a4APPLICATION FOR APPROVAL OF OFF-DUTY EMPLOYMENT (Part It!) (To be completed by prospective off-duty employer) Capedlen Careins Sbonals — Conloer ern sree an ps ration for ‘Department of the City of Kingsland granting permission to employee") to engage in outside off duty ‘mploymant by emplofar, tre undersigned émployer wil hold the Cty of Kingsland, ts lected oficial and employees, and its Police Department, is police chit, managers, supervisors, employees, and agents harmless, indemnity them, and wil pay for thei defense, by an attomey selected by the City of Kingsland, or heir defense from all Tabity that thay might nou 9s a result of any action or omission ether by the Lndorsigned employer, or by sald employee while working for or on behalf ofthe | understand and agree that nether the City of Kingsland nar its Police Department nor its Chief of Police (Kingsland Parties") guarantees or makes any representation concerning the ability, competence, training, or suitability of the employee to perform the Job duties or to serve in the employmant capacty for which we will be employing him/her ‘and | wil not attempt to hold the City of Kingsland, is elected officials and employees, ts Police Department, its police chief, managers, superdsors, employees, or agents, responsible or lala to me nor to mplead them as a joint or a third-party defendant for ‘any labilty that | might have due tothe wilful or negligent acs of sald employee while ‘working for me. | further agree, 2s @ condition of the Clly Manager, or his her designee, approving my ‘employment of sald employee, that | will cover sald employee under my cwn company’s ‘workers’ compensation insurance policy for any and all inesses or injuries which the ‘employes may suffer i the course of performing his/her employment duos for me and lability insurance with coverage inthe amount of §. ‘covering the ‘employee. | agree to pay all overtime pay due tothe employee in any week in which the ‘employee works more than 40 hours for me. | agree thatthe City of Kingsland City Manager, or his/her designee, may, at any tie, ‘and for any reasons which he/she deems reasonable n his/her absolute discretion, deny, or withdraw, permission for said employee to work for me, and that sald action will ‘ot entitle me to make any claim to engage in any suit against the Cy of Kingsland or ts Police Department or is Chief of Police, elected or appointed officials, or their ‘subordinate managers, supervisors, employees, or agents. she ‘Signature ‘Signature Dato Friday, March 02, 2018 =5-POLICE DEPARTMENT APPLICATION PACKAGE For Position of Police Officer “Today's Date: 20-17-17 Are you a native born or naturalized citizen of the US.A.? Circle One: (ES) NO jreyou at leat 2 years atage? Cia One: YEP NO So (Exceptions MAY be given to those who areat least age 18 and are Georgia POST Certified) Ityou lve in Georgia do you havea valid Georgia Driver's License? Circle One: GES NO Print Your Nam Mary SN: a pe i a Date of Birth: 174 Race: cf ‘Marital Status: AL a [Are you a Military Veteran? Cirle One: YES > Are you a Georgia State Certified Police Officer? Cirele One: YES kD GENERAL INSTRUCTIONS “The correct completion of this application package is considered part ofthe inital interview process. You must follow al instructions correctly, Your ability to follow instructions is part ofthe application process. Driver's License Number, State and Expiration Dat ‘The appl Words must be spelled correctly. Be sure to sign each place you are asked to sign or tion must be legible tal Be sure to write N/A where an itom or question is Not Applicable to you. ‘You must inital each page ofthis application package upon completion. ‘The application itself and the two Release of Information consent forms must be notarized. ‘The notary must contain not only a seal but a notary signature as well, All req No ‘re You curently on Taye” sats or subject orca rom another eb? Yes @ IFyou reiwere a Certified Peace Officer (many state, has your cerilcation ever been puton probation, Suspended, or evoKed? ise, prowde a dtaod explanation Use stitonal shect recess “Agency Worked For Reason for POST Aation ForHow tong? | bates Have you ever been charged with or accused of sexual harassment? _ Ifyes, explain. [Aol , on He sh, Trude aq 5k trafeeck Co verter, I did it one cle | a bad top it CLOSING ATTESTATIONS (circio one answer for each question): 1. Have you Isted all disciplinary andlor corrective actions taken by any previous employer against you (this includes verbal or written counseling's,wit-ups, suspensions with or without pay, loss of privileges, probation, publig reprimands, terminations of employment, revocations of permitslicensesieertficatons, etc)? NO NOT APPLICABLE you answeris YES or NOT APPLICABLE, sign hte Jee” ZZ 2. Have you willy withheld any information asked fogn bie Spplcation? YES NO—> Hyer anne 0, eon e_ a 3. Have you been tutto the best of your knowledge ip of yoursesfonses? YESTRO Ifyou answeris YES, sign here age 25 ils 1sYOU ARE AT THE END OF THE APPLICATION PACKAGE. MAKE SURE YOU HAVE ATTACHED ALL OF THE REQUESTED DOCUMENTS You BEFORE SUBMIT THIS APPLICATION PACKAGE OTHERWISE YOUR APPLICATION WILL BE REJECTED. IF YOU UNDERSTAND THE ABOVE STATEMENT INITIAL HERE (Of. erRATA ARAL TONED COMMONWEALTH OF VIRGINIA (CERTIFICATE OF LIVE BIRTH ‘STATE FILE NUMBER: 148-91-049712 NAME OF REGISTRANT: ZECHARIAH MARK PRESLEY DATE OF BIRTH: 0 SEX: MALE PLAGE OF BIRTH: ae ed MAIDEN NAME OF MOTHER: I rne AGE OF MOTHER: a MOTHER'S PLACE OF BIRTH: FLORIDA NAME OF FATHER: — AGE OF FATHER: 20 FATHER'S PLACEOFSIRTH: MN DATE RECORD FILED: AUGUST 7, 1991 8 ) tena August 20,2018Commanwealth af Virginia Bepartment of Hducation This diploma is xfvurded to . Zechariah Mark Presley faho has completed the requirements for graduation from Prince George High School Given at Prince George, Begin, this eleventh day of Fume, Hou thousand and ten. C — Portes 5, Caer Ray! Fon DsCoastal Pines Technical College [Zechariah m. presiey ‘CPTC Reading/Writing/Math/Algebra - TRF ‘Taken Oct 28, 2014 at CPTC - Camden instructional Site Session #17680969, Total Time 01:33:41 Release Report to Postsecondary instutions, High School ‘Student Background and Educational Plans (Time: 00:02:62) ‘Where Diploma: ‘Not Listed English First Lang: Yes ‘Type of HS certificate: High school diploma High School Grad Year: 2010 High Schoo! Not Listed Quarter Credits Earned: 0 ‘Semester Credits Eamed:0 Highest Degree Eamed: Certicate or diploma Major: oval Meier yas a Vaan elbaaro nes COMPASS Math Placement Test ey Note Algebra Placement Domain Pre Algebra ‘Naval Apprentice Technology Programs: Not Program Ready (Program Ready requires an Algebra score of 37 or higher). COMPASS Reading Placement Test Oe ae Te) Placement Test Test Time Note COMPASS Reading (@3" 00:26:40 Placement Domain ‘Naval Apprentice Technology Programs: Program Ready (Minimum Reading score of 79 has been met), (Directions Time: 00:04:29) Placement Test COMPASS Writing Skis Naval Apprentice Technology Programs: ‘Not Program Ready (A Writing score of 62 or greater Is required). igor SaaTe AT ne epeinompan cergeConpmonldepar one TD wEVM Applicant Name: Zechasan Pre Date Received: Fesuay 2017 Date of Informal intervi Da Soe ata PASS Timo 262 O Fa Date #7017 LE Test Score 75% Candidate Profile Tost Date. 8172017 ~ Candidate Profle Fags 101mg wm pet eae oman coin desc Zlorenentored errirtine) wr reed rl cold a postage Date 172047 1D HerayHeavy Deception Indicted Harateaiy Decepion not inated RAEI? Date: 818201 mm Average Score: 22.25% Board Members Ges Solna St GMs. Rachel Borat GL Witiom Use KPO) OL Bian Algood KPO) a Page LetsInclude Name, Date & Time Contacted: CS Soro AI 1 5.242017 @ 11:15am Oe oho S 15:2672017 @ 525m (a Crs 572472077 @ 1555 a eee Ince ares, Dae & Tne Contact a a a oo Include Name, Date & Time Contacted a a a \Mr. Presley's references gave favorable comments, no derogatory information was. obtained. ‘A Criminal and Driving History was examined on Mr. Presley and there was nothing found which would disqualify this applicant from the hiring process, ‘Additional information conceming the details ofthese histories are available. Page 2013PadcitionalN ‘Based on the above information and my investigation into the character of Mr. Zechariah Presley, | do cetily that he has completed the hiring process with postive results Mr, Presley would be hired on the standard 1 year probation with a 2 year Service ‘Agreement in accordance with state law. Pale inspector Office of Professional Standards Kingsland Police Department Reviewed by: Chet Darryl Gris Recommendation TO hire: Recommendation NOT to hire: ‘Aoproval by: Mr ee Sel iy Manager Approved TO ie fa. Disapproved, NOT for hie: Page 303Kemeth Sith Sr Mayor Dares! Gris Chief of Police City of Kingsland Police Department Office of Professional Standards Post Office Box 250, Kingsland, Georgia 31548 (912) 729-8257 Employee Service Agreement ‘This Agreement made and entered into this 24% day of May 2017, by and between the Kingsland Police Department hereinafter called the “Department” and Zechariah Presley herein called the “employee”. WHEREAS the Department deems it necessary and desirable to retain the service of employees ‘who are competent to perform the mental end physical functions and duties of Police Officer, ‘and ifthe employee has been deemed qualified to perform such services forthe City of, Kingsland Police Department. NOW, therefore, for and in consideration of the mutual promise herein contained, the Department and employee agree as follows; 1 loyment ‘The employee fully understands thatthe City of Kingsland is an “At Wil 8s such can terminate the employee at any time without reason or cause, ‘employer and I. Conditions of Emplovmen A. Theemployee agrees to, ‘Successful Completion of the Georgia Basic Law Enforcement Academy. Maintain a state of Georgia driver’ license Maintain Peace Officer and Training Council certification. ‘Meet and maintain standard passing ratings on annual performance evaluations. ‘Meet and maintain a standard passing score on agency PAT. ‘Meet and maintain a standard passing score on annual firearms qualifications. as all other tests deemed appropriate by the Chief of Police. Follow/abide by all portions of the Departmental Standard Operating Marval.‘The employee agrees that the Kingsland Police Department may elect to send the employee to basic mandate and/or such specialized technical training schools as. will enhance the employee's skills and job performance. The employee further understands that these skills are acquired ata considerable cost and in consideration thereto; that upon employment the employee hereby agrees to reimburse the Kingsland Police Department forthe total expense of training, to include salaries or if employed by another Georgia law enforcement agency, as prescribed in OCGA 35-8-22. The expenses which it incurs as a result of any ‘Basic Mandate Training or other formalized required training should the employee's employment be terminated for any reason within a two (2) year period of time after fully completing said school or course of training if requested to do so. The initial fifteen (15) month period willbe billed a fll cost andthe latter nine (9) month period will be billed at half cost. Employee also agrees that failure to meet standards in any ofthe above listed ‘conditions will be eause for termination from employment with the Kingsland Police Department. ‘Employee understands that this Service Agreement is mot to be construed to indicate thatthe employee is guaranteed any specific term of employment by signing this form. have read and understand this document and agree as a condition of employment to maintain those standards as stated in Section Il (Conditions of Employment), Kingsland Police Department, Kingsland Georgia. i b-45-Q beKamath Sah, Dory Gifs “Mayor Chiefof Police City of Kingsland Police Department Office of Professional Standards Post Ofice Box 250, Kingsland, Georgia 31548 (012) 729.8257 ‘TATTOO POLICY ACKNOWLEDGEMENT 1_Lecharial fren have read and understand that the ‘current policy of the Kingsland Police Department as outlined below forbids the display of any tattoo below the standard short sleeve uniform shirt or department polo style shirt at anytime. Several options are listed below to remedy this if it applies now or in the future, In addition any form of “body art” as described below is prohibited from display to the public while in uniform or representing the Kingsland Police Department at any function. 2012-2013 KPD Standard Operating Procedures Manual Chapter 7 8. Tattoo's Its the poliey of the Kingsland Police Department that all uniformed Employees and explorers maintain the highest standards of professional appearance when interacting withthe public and representing the Department. All uniformed employees and explorers are prohibited from displaying any body art, tattoos), intentional scarring, mutilation, or dental ornamentation while on duty or representing the department in any official capacity. Any currently employed uniformed employee and explorer with existing body art, tatoos), intentional scarring, or mutilation that is visible shall Ihave the following options:1. Uniformed employee shall cover existing body art, tattoo(s), intentional scarring, or mutilation by wearing the long-sleeve shirt or compression sleeve. 2. Cover the existing body art, tattoo(s), intentional searring, or mutilation with a skin tone patch or make-up. 3. Have the tattoo(s) or brand(s) removed at the employee's expense. Body art, tattoo(s), brand(s), intentional scarring, and/or mutilation that is not able to be covered or concealed is prohibited. This includes, but is not limited ‘foreign objects inserted under the skin, pierced, spit or forked tongue, ‘and/or stretched out holes in the ears. Uniformed employees and explorers shall not have any dental ornamentation. ‘The use of gold, platinum, silver, or other veneer caps for the purposes of ornamentation are prohibited. Teeth, whether natural, capped, or veneered, shall not be ornamented with designs, jewels, initials, ete. BE Z Knox Witness oeGEORGIA CRIME INFORMATION CENTER AWARENESS STATEMENT ‘Access to Criminal Justice Information, as defined in GCIC Couneil Rule 140-1-02 (amended), ‘and dissemination of such information are governed by state and federal laws and GCIC Councit Rules. Criminal Justice Information cannot be accessed or disseminated by any employee except ‘as directed by superiors and as authorized by approved standard operating procedures which are based on controling state and federal laws, relevant federal regulations andthe Rules of the ‘GCIC Counc (O.CG.A. §35-3-38 establishes criminal penalties fr specific offenses involving obtaining, ‘same statute establishes criminal penalties for disclosing or attempting to disclose techniques or ‘methods employed to ensue the security and privacy of information or data contained in Georgia ‘criminal justice information systems. ‘The Georgia Computer Systems Protection Act (0.C.G.A. §16-9-90t seq) provides forthe protection of pble and private sector computer ystems, including communications inks to suet computer systems. The Act establishes four rimnel offenses, al major felonies, or ‘violations ofthe Act: Computer Theft, Computer Trespass, Computer Invasion of Privacy and ‘Computer Forgery. The eiminal penalties fr each offense caries maximum sentences of een (25) years in prison and/or ines up to $50,000.00, a5 wel es possible civil ramiiations. The ‘Actaloesublishes Computer Password Disclosure as a criminal offense with penalies of one (1) yearin prison and/or 8 $5,000.00 fine. “The Georgia Criminal Justice Information System Network Is operated by the Georgia Crime Information Center in compliance with O.C.G.A. §25-31. All daabeses accesible via CS "Network terminals are protected by the Computer Systems Protection Act. Similar ‘communications and computer systems operated by munilpaVcouny goverment ar also protected by the Act By my signature below, I acknowledge that have read and understand this Awareness Statement. vinenane. Zecharil, Licbyy set LQ bs Reviewed 2013148 Revised 2010Darn. Gris. Mone Pes Chief of Police oat Asst Chief of Police City of Kingsland Police Bepartment Post Office Box 250, Kingsland, Georgia 31548 (912) 729-8254 Fax (912) 729-1750 Oath of Office 4 Zeelasc\frléa —dosoemaly sven ha | il hilly and impartial ischaae the dutes ofa swor li enforcement oficer ofthe City of Kingsland, Georgia othe best of my skill and ability, agreeable to the ordinances ofthe suid city, and the laws and Constitution ofthe State of Georgia and ofthe United States, an Iwill obey ali policies and procedures of the Police Department and te City of Kingsland, Georgia and all ordinances ofthe City of ‘Kingsland, Georgia andthe laws and Constitition ofthe State of Georgia and the United States ‘both while on duty, and offuty, and Iwill fithflly and impartially carry out the instructions and orders ofthe officers appoinied over me, o help me God 1 do further sweat or affirm that I am not the holder of any unaccounted for public money due this stale or any political subdivision or authority thereof; that {am not the holder of any office ‘of trust under the government of the United States, any other state, or any foreign state which, by the laws ofthe State of Georgia, I am prohibited from holding; and that I am otherwise qualified tobe a police officer according tothe Constitution and laws of Georgia. | accept the Law Enforcement Code of Ethics ofthis department as my standard of conduct while ‘on and off duty and swear to faithfully abide by and defend the same, BEA | Signature =KINGSLAND POLICE DEPARTMENT POLICE STANDARD OPERATING PROCEDURES MANUAL RECEIPT FORM Zale al. eb. do hereby certty that | have received or have access to a copy of the 2012 Standard Operating Procedures manual for the Kingsland Potce Department. | further certify that | will carefully read and abide by the contents ofthe Standard Operating Procedures manual. | so understand that in carrying out my duties and responsibilities as an employee of ‘the Kingsland Police Department, my conduct and actions will be governed by the Policies and procedures contained inthe Standard Operating Procedures manual. | further understand that violations ofthe Standard Operating Procedures may be cause for dscipnary act incuding termination of my employment GA CE ature Employes) Date 6S6-/> ‘Signature (wetress) Date (Tobe signed and tured in to the Office of the Chief)Policy Receipt Acknowledgement for the Social Media Policy ‘Thave red and been informed about the content, requirements, and expectation of the sci media ple for employees ofthe Cy of Kingsiand, Georgia. Thave recived a copy ofthe pley and I ‘gree to abide by the plley guidelines asa condition of my employment and my continuing ‘employment wth the Cy of Kingsland, Georgia. {understand that iT have questions, 8 any time, regarding the soc meds policy, wil onaut with iy immediate supervisor or my Human Resources department. Pease read the soil media policy carey to ensure that you understand the pecy before signing thls document wv esi a trvoya ens tame: Zeclene ily ote: 6° 5Georgia New Hire Reporting Form Send competes ferme “Tonsure te highest vl of accuracy, pe prt ety SER BeESER Pram Best Bont GA 30366-0728 a eee om FS (8) 25 8 re tax ne 541-0821 alale 11213 EMPLOYER INFORMATION Ferlerl Employer ID Number (FEIN) _ (pre or e sne FE a spn on yrs ut ep sos ove oS G1 GletereTstorr) Mutipe medical insurance: YN [NT — Insurance Company Name (favelbe to the empoye) Vf ovaablfteec: VN Employer Git Employer State: Zp Code (5 di): KI [NT Gis [te Ja[NJo I GTA] (aliistaTa} Employer Phone: Exiention: Employer Fax zit lelelel ls PIREFaEAPSCSEACEERE | EMPLOYEE INFORMATION Employee Social Security Number (SSN): Employee Starting Salary (Monthly):* = Sa [ oo GleleIlaeR Tale TTT TTT TTT 7 Eplyee Losi ae rarararararat COLE rrrr rrr Eneloree aos a ame TT ] Employee City: Employee State: Zip Code: = Datof Hee Dae of ith ‘ait Day of Wore? Cel T/T T7) & Bilt) CLTITiTtT) Ndi nuance Conary Name" *optional Reports must be submited within 10 days of dato of hire or rehire Questions? Call us at (404) 525-2985 or toll-free 1 (888) 541-0469 5 i ovc20 Ml‘Seta 1 EMPLOVER INFORMATION ey sy psi he Reinet Pn af Kingaland, G2orgin ert Eagle Becta etl Red Ene Bs ar ORS oH Sal ‘SeGeopa anaes Anon ON apne None Bes Zi ah itty taste ee i oon? ester ate 0 Fete Dawei p90 i oe [bech cop e ste otr er oi t] arent BB 14812. rtpn eerie roy oe vgn teeny yer carn Ep br pron at rca ete OS ‘Whose a ane pr bro eeaipae be Fo Pet fens fon a aa BT son i ‘Seto 3, PRIOR EME. OVMENT WIT! OTHER GMERS EMPLOYERS enous od rarer emplyer tata mente f ES yor ue ge? ove ge 9s sowed Mi pw tid EDS cp ae ee ee ‘Sectun 4. EMPLOYEE ACKNOWLEDGMENT ‘nett seen mentite ese ea ‘ey egy fbn eae reeme prt he a af ty ee wae e an, wil Eaminy borcnanroarterinane erases vue 06 yal 12 ‘wean — ay ea Ennio Seat ‘Seto, PENSION COMMITTEE REVIEW & ACCEPTANCE ee pints ea by me, 28th gad ye at TSS al ad arenas. ae rama — COMERS Fom gL WieCappCMENS —YebowComEmponr Pak ConnorMUNICIPAL ASSOCIATION ‘Suu 1 EMPLOYEE. INFORMATION moves nase Zecbarah, a. ae ‘easy pbs an moran Singshad Police Departnost ‘Sect, PRIMARY RENESICLARY. BENET CIY ce ptonpe a ety tho pylon yt er ft set be tm oe cts y Enpe heme Pa ace © aden CEO ‘Misa ime Bonen ES) Py et Sa ae RE 129 ic i Coe: OMe Ae tao ey Bey A nereeneen ra) a) apes) ‘Sen 3 SECONDARY BENPEICIARY {ey deat he tiie sand pense (ONLY ONE PERSON MAY BE DESIGNATED) os xy SECO eninge) BENEFICIARY. ee vera des ty th mbps fy tn by ured FRBNY BENEFICARY esse ee ra [owt fly girs Reem Pn snd be Coad Brat Be, Syn Ey Set et nc no a a | ee eke: stented ell ee ee = . ‘Sison 4, EMPLOVES SIGNATURE | ty ote ove bmn eed at Des fy elt I ted ove ‘siping eens ‘ee rat nee ttre meer sea io Comme Scary enti cg foe er anand oye mae et ‘tiny deiaon a sng, sl ae etn a il ae pede ol ‘em ieccsounes | Dassignt Of o 212. ‘aes — ty ee att eo i ono WELT ‘Ses, RECEIPT RY PEASION COMMITTEE SECRETARY, eS eT COMERS WANES Yeon caeCity of Kingsland, Georgia or ae a Hone Prove: UGMEMNNNN ——_Atomate Phone: D 5: TT ane ee soca Sect eer Come Spouse's npc: SAR So.5's Work Pre: “Te _ Employee 10: = Supanisor ‘eparment ‘Werk Location: mal Ades: Work Prove cet Prone; {op Stan Date: Satay 8 Adress: o Sa Primary Prone: UMS Altemate Phone: _¢ _) Reto: ST‘STATE OF GEORGIA EMPLOYEE'S WITHHOLDING ALLOWANCE CERTIFICATE Ta YOUR FULL WANE 7B, YOUR SOCAL SECURITY NUNBER. Zechwrik, Mark fretly ante Soa, a ara Raa) Be (0 DP CODE 5 EAS RTE RETEST = {. MARITAL STATUS 0 {Aare Fig ict oe poise wong 6 ADOMONAL ALLOWANCES a Enerdor ter? ‘wortcheet below mtb complied) atte Fing Sper EnrOort oo Hondo Husa {6 ADDONAL WITHHOLDING Emer ert ‘WORKSHEET FOR CALCULATING ADDITIONAL ALLOWANCES (ust bo comploted In order to ntor an amount on atop 6) 4. COMPLETE THIS LINE ONLY If USING STANDARD DEDUCTION: Yourselt 1 Ago8 orover Bind Spouse: C1 Ages orover [Bind Number of boxes checked _x 1800. [ADDITIONAL ALLOWANCES FOR DEDUCTIONS: Fedora! Estimated Homz0d Deductont cnn se (Georgia Standard Deduction (enter one): SinglaMead of Household $2,900, Each Spouse 31.500 8 Sublet Line B fom Line Ae ‘Atowabie Deductions to Federal Austd Gros Income ‘Ad tho Amounts on Lines 1,20, 84 20 nnn etato of Taxable Income not Subject to Winokdng Subiract Line F fom Line & (zero or less, stop her). Divide the Amount on Line G by $3,000. Entor iota here and on Lin 8 above... (ithe maximum number of adel atowances you can can. th rade is ver 1,500 ound wp) BPe zemmoe 7. LETTER USED Marta! Sats A 8,0, o<) Gil ‘TOTAL ALLOWANCES (Teta Los 3-6) SB The er natn a aio rippers Tau = (Do nol completo Lines 3-7 calming @xOnp ead ha Used inavcions on pape Tonos compntng Bi seca 1} cam emen fom wicking becouse ncured ra Gerla nena ax aby tt yas and onl expect fave a Georgia come tax aby ts yor. check hore 1) eat mat am ot ute © Georgi winking bacaoe meat ho conons st et under te Servcamambers ‘Ch Ratet Act os emendod by to tary Spouses Resoncy Rett Ac ax prowsod on pogo 2. My eats of eatsoca —____ ty spouses eervcorobey st of restene “me aan reise imastbo ho sanats be amngt Chock hore Cl Teena, peat ofp fon erage aro tlemod on Gis Form G4 Als, Lauerze my omployr te Godt per ey parodia ado! amout lod Dove. ‘De not accept forms cling sddtona!atowances unas the worksheet has boon completed Do not accept forme ‘leming exempt f numbers are weition on Lins 3-7, =1) Check the it bx fy gay to clam exempt fom witoling, You can clin exemp if you fled ecg ncome te ‘etm ht yearend the amount Lin 4 of For S00EZor Line 1 of orm 300 wes ar, ad you expect flea Georgia {sc reum ls eran wil ot ae tx abil. You ot aim exempt you di wt fla Georg income ex eum {rte previous tx yr. Raclvng a efund i the previous tax yar don bet guaif You team expt EXAMPLES: Your enployer wield 300 of Georgi income tx fom you wages. The mont on Lin 4 of Form S052. (Gr Line 1 of Form 50) wes $100. Your tn laby& the moat on Line (or Lie 16 thei, you do oat qual © 2 Ike mse of seviemanter is nied th proton ofthe Mitr Spouses Residency Rell Actin nthe stunt lea wing exemption frm in sh oer ste, the spouse requred ub a Geowgia Form Gt Se hat wit wl ooar as regued by Georg Law when» Geog comin we n moe sae end ‘wild ot ued by uch ter ate. Ite spouse oe ot fil ot he om, he employer hl wield ‘Georgi icone tx site moses single with 2 lowers, ‘Werkabeet for eaalang odio allowances. Enter informaion a requested by cch oe. Fot Line 2, et ten sich ‘5 Retenent come Exchsin, US. Obptony and oe lone dedoton pe Goria Law, se the Ti boot or ‘Dose complete Lines 37 dag exempt OC... § 487-102 resin you a complete end shi Form Go your employer inode to ve tx wt fe your ‘wages, By comely compleing tis frm Jou cna bs umount of tx with! oma your tnt Ly. Fala sa ‘ope complaed For O-t will aus our employer wining xe ugh ou se se wi re alowanssForm W4 (2047) Saeco Eaters Seeaeeees es Se area ee Pecmeeletesias ene [ SE Nepean j eigenen necasiagetetinn orem (© Erte“ for jour spouso, Sut ou may choose fener“. youare marie anahave eter a wang spews or mare ‘per oneon Erg “0 may hep you ra hang oe tx wets) 1D _Erernunberf dependents ter than your spouse or oul you wileltin on your tx lun & yu Wf as hoa of Reveholon your tae oe condtons naar esd of househol shee) F tyouhae east $200 of chil or depandent cae expenses fo which youpian 6 ia (Mote: Do notin asic payments See Pu. 5, Ci and Dependant Cae Expres fr eta) (2 Gna Tax Crt (rctaingetonl rc cra.So Pub O72, Chi Tox Cre oem, * yourtots ca wt ees han $700 (100000 rare) oar" each lg chi anos “Hou ave oer tg con aloes" i youve fv crate sgl ctr. 1 journey 7000 a $8400 0000 en HCOOH mare ne “Ioreacheigioci. 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Kegp he op pa for ou rece —~ rom WHA Employee’s Withholding Allowance Certificate ‘ona He-04 pe ral a 2017 Parecere! a Fa SE TT a Tee ae Tired lahat engem Nb tre rere rte cern mrs ic tr 1 sists as atv on our ry ‘heather Yom e075 otra ements >) 5) Taal rumba of alowanes Yous caring Wonlna Habre oom We apaleabe worst onpape@) 8 Aeconl amour. ary, yu war hed tom exh paerack ais 7 ea examoton fom witeing fr 207, rer at Imes beth th folewng condone for exemption. ‘Lan yoar hada igh oar of al ede nar tax wilted beceuse had no aby. a 1h your apo ote of afer nears tax whe Boeate | eset ate et iyoumet som condor we "erat we Se a Enpoyn' donee (edie antes yous) » par 6) 3 Eres ane en Rats Oa mane S) [FOORDA] Weer eetaaR ANT Far nny haan Paparwor Ruan at tan ae pape ama rawrom re? a ean PTET rn aren cn oon eT 1 Si erence dar anon, wc an ees et cea es Sai ce etme ge nem eo eg recent forts Bt at oy oar cea wae a8 Fjuetnlcthanena tv sions tudes bannav edad ecseg seep aL Te rondtigioaay seh aus i f 151270011 maria ting ant ota wanton ] 2 ewer | e03s0ifnoadottewena 0 ang mare ing eer ‘Subtract 2 tom ne Mamworlem om {sara xm f you 2017 users orem a ry eon tandas etuton ie P68) ‘ddim 3 we are rr a ce wy ane fy oe foe Gey Cat ‘etang Atowancs fr 2017 Frm id weahowt PBIB} nen rae etna of our 2017 orwagencomo (uh an dnc re) ‘Sitwactine tum bw. aso rie, oer" ‘Dido to aout one 7 by 8.50 ender hrs he Drop ay stn ‘rare rumba tn Personal Alomaneos Wortahoot Ine pago = ‘arsed rr aor yu sn Two carer Se Wee ‘earn i alo ra atom, op er neta o Fem Wa r Two earner Roa Use Wis wore ny bo ineuctens nce te Hon pepe 1 ee you Re. 1 Steen tom nH page renin 1 aoe ou ed he Datos nd Aina Wesee)—¢ 2 ind he ruben Tele 1 blow fut apps to 2 LOWEST pay end eta hr. However ura tng ty noe fo ea ar SD eo et ee rome = een ntenenentnnene 2 {nw fa mor han or og fra 2 ett ne 2 or 1 Ex th rut hare 2, rer a") anon Ferm Whe, pga Do not ashe se ls werkt. Note HE ston tno 2 ear” on Fom Ws re 8 G8. Complete ies 4 gh blow ‘tg eon! woking eat nanos wai a Yura wx ture umbarfomino Zt iaweeahest s+ ‘ norte onbarfonine teftiawedabest LL 5 SwmectinStominad. vn ne Fe tha ean Tebo2 below ht spp toe HOHEST payig ob andere Rha ‘uty nw 7 yin sede theresa. Til to atonal arr wot ned = iN ‘ 6 I Ng; a Lit Se anne a, Sepaiciienmeteaiterusttosems toes steeds Su Sarparascteeescsaeany aneimepay nT” ied trgts as cos ney ans eal Swenson re etn boone none Spee ieeanteseemey tern na toaEmployee Direct Deposit Enrollment Form on int gst, snl hom ai your pel deck otha en Ath lh cing a rst Meningie yr a eyo ase Kanes unset hats be ac tte on a (Sfnts. Trp ema jus ty Beil ek ICR ding we nn yc ifn es ie 14 O323usu 781+ aeausk7ede. Dioy Genie Roatan rrr) Gas aSSpecum tay (Diem mae ain Sinem ogemcemrracoe IMPORTANT! Plese read and sign before completing {ue sutra he yo ant we ay tas oe ‘25 Por nrc Du men eye eel Cay fgg aetna eye ang ss ‘edhe soa sea auc Giy of asty a eran ana ee ep na othe eer Th sbi ol es te Cy af andl Dkr seed wie son stn ec ied ch TRicraiatow eC aeplednd tt um pound aan Employee None Zechorcl, fy Sci $y LS Employee Signaure Zed d FE- = Date: 6 -/- 17. st iy athe nel ata rete“) eon ‘Account Information “The lst em must be forthe remaining amount owed 19 you, To disrbute to more account, please complete anther form. [Make sure indicate what tobe deposited less than your total met paycheck, 1. Bank Name/Ciy/State: 1 1 TT Ne Checking Savings other I wish to deposit: or Entire Net Amount of account along 2. Bank NamelCity State: Routing Transits COchesking Savings Other wish a deposit 5 or Cte Net Amount _—Aecount Number: 3, Bank NameCityState Routing Transits “Account Number Clewecking Savings Other I wish o depot: § or Dente Net Amount ATTENTION {Employers must kep ech erga employe enrall yeas threaten. at form on file at longa he employe sing Diret Deposit and for woLISTS OF ACCEPTABLE DOCUMENTS ‘All documents must be UNEXPIRED. Employees may present one selection fom List A ‘a combination of ene selection Wor Lis B and one selection rom ist. usta usta uste Documents that stash (| Cocament tht Estab Documents that stich Sotnidenty and dant Employment huthorzaon Employment Authoration BR a0 f. Us.Pemotos Pempotcus | [- Dewaionm aw Dmgmnaiye | 1. Alea net Amano, Shocrccywemanionstte’" |" Gagunate eco ronson Femara Cava |-| Uamdsunesoscestcotares | ebiwig aon — [| proteaaph inert sch 8 (1) NOTVALD FOR EMPLOYMENT 3. Foreign passport contains 8 ‘eporar 51 amp etary "581 primed notation ena maine readebe immigrant vis a Enploymant Adboteaion Dooimert {tateomain a photograph Fom (@ VAUD FOR WORK ONLY WT INS AUTHORZAMON Jt Weard ime by eset tw eress!| —) vaLio FOR WORKONLY WITH ‘goverment agence or eis, DAS AUTHORIZATION ‘Eomaton sch a rao, ate often & Csi of ih Area aod ‘ender hegh eye cla, and ares | Dj De Deparment of Site For re) Poses). Behold wih a proogaph Fora prinmaret ion sahatznd Gotten of Repo of Bh tower aspecc empire "Yatra regeaton cars ‘suns ye Coperment St ecaue ois re tas (Fam 08-r360, 1. Foreign passport and 1 For 04 o Form 04 that has tha following: US. Coest Guard Merchant Mariner a nae oe (Tg same name same pasipor} | ce bang sn ofl sol Native Arern wow cocorent [6 Nate scone (@)Anendorcement fhe ars = i a ‘onmmigrni stats aera as || Divers ceo sevedby @Canatan [6 ys cazen 10 Cad (Fom 17 ‘hat pered ofenceremanthat |, | _govemmat aubriy ea ‘ote expe and he i 7 entation Card Use of [oposod ampioymentis natin || For persons under age 18 who are | ”” Restart cizenin the Unaed oumcwihanyrecretorsr | | unableto presenta document | State (Fom 179), Etats ented oni form | Usted above: | Employment automaton & casper te Fede Stet | a eanaraantorepatord onment sued bye sia FSM) or he Repl rte Homeland Socurty the Mare ards (wan Frm |, Cine Gor Psst nod Severe Ser Fom r90hiesatng [ nonimmigrant arisen unéerbe |. [32 Daycare ornare stool ord ol ree Assoition Between (Boni Ste andthe FSM orl | Examples of many of these documents appear In Part 8 of the Handbook for Employers (M-274). Refer tothe instructions for more information about acceptable receipts. Fame TAROI6N PagersAffidavit Verifying Status for City of Kingsland Public Benefit By executing ths affidavit under outh, as an applicant fora City of Kingsland, Georgia public benefit as referenced in 0.C.G.A. Section 50-36-1, lam stating the following with respect to my application for a City of Kingsland, Georgia, public benefit for {insert name). 1) am Unie Sates Caen on 2) __T am lel peerunent resent 18 years of age oor or 1am an othervise ‘pale alien ornotramgynt under the Fede Immigration and Netonaiy Act 18 Yours ge older and awl preset inthe United States. © ln making the sbove representation under th I unertand thet ay pron who knowingly and willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall be guilty of violation of Code Section 16-10-20 ofthe Official Code of Georgia. S112 ‘oF Applicant Date Zeccherise_froky Printed Name SUBSCRIBED AND SWORN * ———— [BEFORE ME ON THIS THE Alien Registration Number for Non-Citizens [PF oav or Dine: 20 11 My Commission ‘Note: O.C.G.A. §50-36-1()@2) requires that aliens under the Federal Immigration and ‘Nationality Act, Tite 8 U.S.C. as amended, provide their alien registration number. Because legal permanent residents are included in the federal definition of "alien, legal permanent residents, ‘ust also provide their alien registration number. Qualified aliens that do not have an alien registration number may supply another identifying numberPOST OFFER OF EMPLOYMENT MEDICAL INQUIRY Responses to there question are completly confdenil and wil be ited only I necter to determine ay reasonable accommodations equed fr any work you may perarm whater any health conden may poses dec treat of airy 0 ours or thers, toast wth treatment of ny werkelted jury, ofr any other lawful purpose. ame Zechwrid Presi Department: Kingsland Poston: fol offer Tothebes of your mowedge do youhaveorhaveyouhad any of he following edi condtons? (For "ye" responses, nets the nature fury o tines and name of physian nthe remars section) asus YES oro: —+ totepsy 2. Diabetes So artis ee amputated oot. arm ‘orhand 5 Lasef sight of one or both ‘eyes ors pra os of sight esta bit frm Pohmalis 2. carer pay oie rote 9. Parkinson's deeace 30. Cadlovarcdar orders 2. Tubereuons ental asabty folowing confinement for ‘resonant in arecopnined ‘medial or mental instion| fora prod in exes of sx monte 33, Hemophtia 1, Sila cel anemia 5s cron steamers it stoner mt ne 27, Manele dys 0phy 8 Neatng oe 18. compressed a soquels Ze: seater nur or probions ar tack eonaions ident below) tacky back pln which requred medal estmert e backsuey . daganernive dsc disease Te mull back strains Tie erenibek pan Te. herniated de 22, Neckcondton dentty below) a neck lay Tle neck pin which roqured ‘redial reatment eck ree egeneratve dsc dense mule neck trains ‘oni eck ein hemited ase a lefelnee gery Toe ightinee surgery Te other (en) 28 Hireplacerent surgery 25: setng of any ent which quired ‘medial eatment 26, Hema Carpal Tunnel Syndrome 28. Sager (epin) tevats Thal a _sty asa chil ja He ye too, Et crm te (ie sal Zin Fad fp Probl Sanye 9 1 Zeus fist _femloen, stax hth sbovefomatins rue and compete th best of my knowledge Sone trons oe GP —_ of 112 Sgptureoftmployer—_ at,Georgia Municipal Employees Benefit System Affidavit Verifying Applicant's Lawful Immigration Status ‘As Applet oben snide Goa Manic Eaplyes elt yen (MEDS) Ipriat Applet Ps ladle and Lax ame ero]: Zestargh Pua Pasty nn ‘state the following under oath [check (1), (2) or (3) below]: 7 tama United stats citizen @ ‘Tama legal permanent resident ofthe United States ® 1am a qualifed alien or non-immigant under the Federal Immigntion and [Nationality Act with an alien number issued by the Deparment of Homeland ‘Security or oer federal immigration ageney. My alien registration number® issued by the Department of Homeland Secuiy or other federal immigration agency is also hereby verify that Iam 18 years of age or older and have provided at least one secure and verfible document, as required by O.C.G.A. §50-36-1(0)(1, wit his affidavit. The secure and verifiable document provided with this efidevit can best be classified as: understand thu this affidavit is not comple until Ihave provided such dooumentation, In making th shove representation under oath, I understand that any person who Imowingly and willfly makes a fhlse, fstous, of fraudulent statement o representation in an affidavit shall be guilty of a violation of O.CGA. § 16-10-20, and face criminal penalties as allowed by such criminal statute Bxecwed ia_Kingsland (iy), Genrgia__(sats). 6-4. 12 Sepia at Bia Bay Vea —— . : } | Ach ‘aR aber Epp lee pad ssc AND 5 SERORE MEON TAS Nosy Pe sea ne “Note: OCA. §50:361(0(2) rogue or non-immigrant under the fora Immigeucn aad Natioeality Ac, Tile 8 ‘USC, wands rove roe mp ber fou ae sq sen at yo dant bem sen egnon sabe, You ate to GMEDG Member Emplyr: Ths applet wl ot be deemed complete ula «copy of the Applcn’sseure end ‘ets dunt or proved sd pasted ye Ataray Genera parent o GCA § 30-95) amare or aaCity of Kingsland, Georgia ACKNOWLEDGMENT OF RECEIPT OF EMPLOYEE HANDBOOK. ‘The Employee Handbook contains important information about the City, and T understand that I should consul the Human Resourees Manager regarding any questions not answered in the handbook. have entered into my employment relationship withthe Cty of Kingsland voluntarily and understand that there is no specified length of employment. Accordingly, ether the City or Tn terminate the relationship at will at any time, with or without cause, and with or without sévance notice. T understand and agre that no person may enter into an employment agreement for any specified period of ime, or make any agreement contrary tothe Citys stated employment-at-will policy. Since the information, polices, and benefits described herein are subject to change at any time, I tcknowledge that revisions to the handbook may oocur, except to the City’s policy of employment-a-will, All such changes will generally be communicated through official notices, and [understand that revised information may supersede, modify or eliminate existing policies. Only the Mayor and City Council has the ability to adopt any revisions to the polices in this handbook, Furthermore, understand that this handbook is neither a contract of employment no a legally binding tgreement. I have had an opportunity to read the handbook, and I understand that I may ask my supervisor of any employee of the Human Resources Department any questions I might have concerning the handbook. I accept the terms of the handbook. I also understand tht it is my responsibilty to comply with the policies contained in this handbook, and any revisions made tit. 1 ‘ther agree tha iT remain withthe City following any modifications tothe handbook, I thereby accept and agree to such changes. have received a copy ofthe City of Kingsland’s Employee Handbook on the date listed below. 1 ‘understand that I am expected to read the entire handbook. Additionally, 1 will sign this Acknowledgment of Receipt and I understand that ths form wil be retained in my persone! file.City of Kingsland, Georgia EMPLOYEE SAFETY MANUAL RECEIPT ACKNOWLEDGMENT (Lane to bestgned by emplyee once be has recived the employes safety manuel and understands is efecd I have received my copy of the City of Kingsland Safety Policy Manual, It is my responsibility to read and understand the matters set forth in this Manual. It is a guide to City’s safety policies and procedures. T understand and acknowledge that the City has the right, without prior notice, to modify, amend or terminate policies, practices, benefit plans, and other institutional programs within the limits and requirements imposed by law. Signeds ya Return signed form to Human ResourcesCity of Kingsland, Georgia Probation Acknowledgement 1, Zederal, Aw Preity, understand that a newly hired employee of the City of Kingsland, Georgia, I willbe working in a probationary period of twelve (12) months, beginning on the date that I bepin my employment. The terms ofthis probation are that I willbe subject to immediate dismissal should it becomeCity of Kingsland Post Offs Box 250, Kingsland, Georgia 31586 BoINT63 = ODS ACKNOWLEDGMENT. Thave received a copy ofthe Job Description and have read and understand its contents Zechoryh Presley fae nl aa ae pleue2 EZ _- on Employee Sigiatare Date “Supervisor's Signature DateNotice of Workers’ Compensation Procedures ‘This is to certify that | have read and understand the Workers’ Compensation PANEL OF PHYSICIANS notice. | understand that when | am involved in an on-the ob injury my employer wil pay medical costs for treatment by the physicians) | select from the Panel of Physicians. If | desire to obtain medical services from a physician not listed on the Panel, i may do so: however, | wil be lable for those medical expenses. The physiclan’selected from the Panel of Physicians may arrange for appropriate ‘consultations, referrals, and other specialized medical services as the nature of the injury requires. if | am dissatisfied with the physician selected, | may make cone change without permission to a second physician also listed on the Panel. Upon notification of the employer or its administrator, an Independent Medical Examination may be elected as set forth by the law. However, any further changes require the permission of the employer/insurer, setfnsurer claims fice, or the State Board of Workers’ Compensation. In the case of a bona-fide emergency involving severe injury or when a Panel of Physicians is not available, | should seek medical care from the nearest Hospital Emergency Room. However, all folow-up care must, thereafter, be rendered by ‘a physician from the Panel, or a Panel Physician’s referral. | further understand that | must notify my immediate supervisor or a member of the departments administrative staff or the Human Resources Department a3. ‘s00n the injury occurs, regardless of the extent of the injury, and when possible prior to seeking treatment. | understand that the treating physician will verify my ‘employment and eligibility for treatment with my employer before commencing treatment unless the nature of the injury so prohibits. Delay in notification may result in denial of payment for medical services rendered. Zecarigl, _tiesley Er ‘lease print name) Social Security # Signature of Employes) Date ‘Gignature of Witness) Date| CASTLEBRANCH © RESULTS SUMMARY | eewcessttencenen.com SS) ee Company Name: CITY OF KINGSLAND Order Date: 057902017 = ‘Company ID: 1G41 dor TT as First Name: ZECHARIAH Date of Birth (008) SBPI091 ) Middle Name: M Social Security Number ($N): soca stent rt PRESLEY ZEST 3 SUED ens Wat PRESLEY ESHA rast SSE inna meer sats ae sia rary te TREE EOTRINT oe Saree ‘Sere acs at enters earn dat See atleast uri fas ma us rare tyes at rgnatone eng ry ‘eiSee pm cai ot) sisaeCASTLEBRANCH © ‘STATEWIDE CRIMINAL RESULTS Company: CITY OF KINGSLAND Oe Item Date: 05/90/2017 ‘Name: ZECHARIAH M PRESLEY Date of Birth (O08) ammmR'991 Social Security Number (SSN) Location: US - GEORGIA ‘CASE MUNBER 201774632 1S A CONFIRMED HATCH, [es Secton ‘Name. fet PRESLEY, ZECHARIAN MARK 108 ene: ames ‘SEN on fe: = ‘eden on te NONE REPORTED. oy: NONE REPORTED. Stat: NONE REPORTED. (uring NONE REPORTED. 2p NONE REPORTED. ‘eros Vess By: NOME REPORTED. ‘vers sence Number NONE REPORTED. ral Intron Repoted ott CAUDEN, GA Cave Number zorrTaese Case Sau DisPosED [Eimaaettorntion ‘count 7 Lvl of Crags: MSOEMEANOR Charge: FLEENG OR ATTEMPTING TO ELUDE A POLICE OFFICER. Pree [NONE REPORTED. Vert DistesseD Lvl of Canton NONE REPORTED. ones a NONE REPORTED. ‘Sentance: NONE REPORTED. Offense Date sooner Talat: NONE REPORTED. iposion Oat cuneate ‘STATE IDENTIFGATION NUMBER: GAAOSO20X‘sures hav minum scp 7 yan reas eerise ee. Teprsscing eco ay Dango ba nun unto, Ase ‘Snir clu a cons combat a stwing. woe vue paring tare eat ta, a bith aon Sx oo ond ‘Seal vty ar, rn ects gnuray de al nao cl serty ror h ea. Cas Orn mine oc pene ‘Sttace reborn quoston ts paso lb recta veces So ep oh a sion rch “peeing ncn at arent ban of ea ene Fr ans coy OaCASTLEBRANC! © ‘SOCIAL SECURITY ALERT RESULTS ‘Company: CITY OF KINGSLAND Order em tem Date: 05/30/2017 Name: ZECHARIAH M PRESLEY Date of Birth (DOB): 1991 ‘Soclal Security Number (SSN) iow Location: US - NATIONWIDE oie internation iy Aart ‘Bond ona search of ple and palo dlaboos ha along amaton assed wih prod soda secuy rumor ‘name infomation ate obi infomation Epunwiumes.cy mo: ZECHARIAH M PRESLEY ra ZECHARIAH M PRESLEY ra “Tho cy way vert a Sokal Socury Number tough the Sock SocutyAdminsaon (SSA) The SSA coast alow ‘ir pates, ning employment seein compares, very Sell Sezity Nenbes, Vefaon ofa Socal Secrty ‘umber can ba doo ob employer and only ater Py hae xenGed a ob taro an inva. To eran soy ‘Social Secuy Nabe, cal 1800-72 270 Phase hav he erpoyer's nano as Lappare one Sell Soc ead De (ft Sox and our compan Feral EN numba rosy to xpedio his roses. ‘cl soy umber rma esas gry onto nani ston Asstt aiovea congue Preparing ce reso ran, ty ner ast Cost ‘Sninaso ar bongt he mca ution Wino ta ne procs rcrs Son spy there sta Cate Saneh ‘Sper at ganzatane stp ary cama ara recrn ae ator ne wl gotten, Fr quan creo ee ‘eee pest o15S008CASTLEBRANCH RESIDENCY HISTORY RESULTS wes.castiehraveh.tom Company. CITY OF KINGSLAND ores item Date: 08/002017 Date of Birth (C8 Nm 231 Social Security Number (SSF ) Name: ZECHARIAH_M_PRESLEY Location: US - NATIONWIDE Alicant Provided itormation ees Wit ame acess ‘dates ZECHARIAH M PRESLEY ert2019 To oars ZECHARIAH PRESLEY ‘Sanezote Toosnage17 ZECHARIAH M PRESLEY onazot0 To o4gan0tt ‘ZEGHARIONLM PRESLEY xzcts 0 ostz0t7 ZECHARIAH M PRESLEY ‘rowzpt2 To uanazos oak 2 PRESLEY rowaota Touaraao's ‘tis goesie or ames, acdressen andor dts be fepated at ar ot atmalely cerned oe entfos sbi batearch.nacitateniermaionc Npienly envead by eels ony err in a eel ea sto Mthe pas. ‘haem aman no? reso ro Te poco abe wh bi ni Aue ‘ca sei rater ral ed uray ont nce = sas eect ranour hes east ‘aa race bang fs usin Mp hat he aoe cr Som sy Salman nn oy cial srr ore ote nam sn Fo san ean BaeZechariah M Presley MELEE ‘Background check results from Castle Branch, Inc. ae available olin at ww. CasteBranch.com. To view resus for the applicant above, enter the Pas provide below in the "view backgraund check” box on the website. Indviul applicants may also review ther results using this information. Caste Branch backsround check results cantaina seal of certification and a unique password (ePass). As requested, background check results may be faxes, emalled or printed. Reviewing a backgrauns chek aiectly fom te Castle ‘Branch website provides a real-time lok at results. This assures tht the results are accurate and the applicant has not tampered with them, ePass ZNYLP3 date 06-01-2017 leas contact us with ny gu that you may have o your organization woul Ika moe infomation aout or sees Cwvmeastbranchcom Phone (888) 723-4263, ‘sntomerserice@easebranch comPara informacién en espafo, visite www.consumerfinance.gowlearnmoreo escribe ala Consumer Financlal Protection Bureau, 1700 G Sireet N.W., Washington, DC 20552. ‘A Summary of Your Rights Under the Fair Credit Reporting Act ‘The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, faimess, and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is @ ‘summary of your major rights under the FCRA. For more information, including information ‘about additional rights, go to www.consumerfinance.gov/learamore or write to: Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552, + You must be told i information in your file has been used against you. Anyone who uses & ‘credit report or another typeof consumer report to deny your application for credit, insurance, or ‘employment — orto take another adverse ation against you —must tell you, and must give you ‘the name, addres, and phone number ofthe agency that provided the information. + You have the right o know what i in your file, You may request and obtain all the {information about you in te files ofa consumer reporting agency (your “file disclosure"). You ‘wil be required to provide proper identification, which may include your Social Security number. In many cases, the disclosure willbe free. You ae entitled toa fre file disclosure ift “a person has taken adverse action against you because of information in your credit report; + you are the vietim of identify thet and place a fraud alert in your file; + your file contains inaccurate information asa result of fraud; + you are on public assistance; + you are unemployed but expect to apply for employment within 60 days. In addition, all consumers are entitled to one free disclosure every 12 months upon request from cach nationwide credit breau and from nationwide specialty consumer reporting agencies. See \wonw.consumerfinance gov/learamore for additional information. + You have the right o ask fora credit score. Credit scores are numerical summaries of your credit-worthness based on information from credit bureaus, You may request a credit score from consumer reporting agencies that create scores or distribute scores used in residential real ‘property loans, but you will have to pay for it. In some mortgage transactions, you will receive ‘credit score information for free ftom the mortgage lender. + You have the right to dispute incomplete or inaccurate information. Ifyou identify information in your file thats incomplete or inaccurate, and report it tothe consumer reporting agency, the agency must investigate unless your dispute is frivolous. See ‘wonw.consumerfinance-gov/learnmore for an explanation of dispute procedures. + Consumer reporting agencies must correct or delete inaccurate, incomplete, or ‘unverifiable information. Inaccurate, incomplete or unverifiable information must be removedor corrected usually within 30 days. However, a consumer reporting agency may continue to report information it has verified as accurate. + Consumer reporting agencies may not report outdated negative information. In most ‘cases, a consumer reporting agency may not report negative information that s more than seven years old, or bankruptcies that are more than 10 years old. + Access to your files limited. A consumer reporting agency may provide information about ‘you only to people with a valid need ~ usually o consider an application with a creditor, insurer, ‘employer, landlord, or other business. The FCRA specifies those with a valid need for access. + You must give your consent for reports tobe provided to employers. A consumer reporting agency may not give out information about you to your employer, ora potential employer, ‘without your written consent given tothe employer. Written consent generally is not required in the trucking industry. For more information, goto www.consumerfinance.gov/leammore. + You may limit “prescreened” offers of credit and insurance you get based on information {in your credit report. Unsolicited “prescreened” offers for credit and insurance must nelude a toll-free phone number you can call i you choose to remave your name and address from the lists these offers are based on. You may opt-out withthe nationwide credit bureaus at 1-888-567- 8688, + You may seek damages from violators. Ifa consumer reporting agency o, in some eases, a user of consumer reports ora furisher of information toa consunner reporting agency violates the FCRA, you may be able to sue in state or federal court. + Identity theft vietims and active duty military personnel have additional rights, For more ‘information, visit www. consumerfinance.gov"learnmore‘States may enforce the CRA, and many states have their own consumer reporting laws. In some cases, you may have more rights under state law. For more information, contact ur etate olen consumer protection agency or your sate Attorney General. Bor ‘information about your federal rights, contact: ‘TYPE OF BUSINESS: {12 Ba, sig ection and et urn wh it cst et ‘rr 0 ben enero. Suh tos pt wnt es, sky eccors, oF cet (Gio tbe out maaan bare 4. Cris Stet Bre Tnsptaton Boo (5 Cras Sut tPatr an Spr A 621 {sat Buoss stan Compares 7, Bota nd Dot 9, Fea! Lan ats, Fdut an Bar aston Fee Tomects ect arn ta Pocono anos 4, ton ance Conan rs Alber Gufs etnd FE gar fe oni cee opt how ra rte Cos Corman Resse = Cn Ginsetr