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    The falsified applications of Carmine Marceno.

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    The falsified applications of Carmine Marceno.

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    4K views25 pages

    Carmine Marceno Lee County and Collier County Applications

    Uploaded by

    Tim Brown
    The falsified applications of Carmine Marceno.

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 25
    AOOAN SY, Mlarceno, acmine D. Position(s) Requested (number and istin orden: LAW. EN FercemenT™ Collier County Sheriff's Office Don Hunter, Sheriff Application ‘The Collier County Sheriff's Office is an Equal Opportunity Employer. We consider applicants or all positions without regard to race, color national origin, sex, physical disability, religion or any other legally protected status. 4 Instructions: Application may be printed, in your own handwriting, legibly in ink or typewritten. This is your application. (f additional space is needed, please refer to question number and add information on 8-1/2x 11 inch paper.ifyou are provided a conditional offer ofa position, you will be required to complete ‘a questionnaire with detailed backaround information, Once received by the CCSO, we must retain custody of the application. Portions of the application are subject to disclosure unde Florida's Public Records Laws. officer eae Social Security Number: MARCEND CARMINE Dominic. (Cast Name) First Name) ‘Wide Name) Name: Other Listall other names you have used with time periods used (e.g. maiden, former allas(es) None i e Education:List highest level attained, year attained, and type of degree (if applicable). REGENTS—-HiGH-School -OiPhma Just below ~ aw ASSOCIATES ~OEuree Law Enforcement or Corrections Officer certification (state when obtained and where): Completed _LAw EwroecemetT E@unealency NY STATE _ceeTiFco , NY STATE oF TRAINING Are you willing to work shifts? at SPT.C. Nights: Yes QNo Evenings: Yes CINo Weekends: fi{Yes CINo Typing or Keyboarding speed: — ‘Computer programs (software) used in your current or prior position: Miltary experience, if applicable List date(s) of active duty, branch, highest rank obtained and type of discharge. Nowe ae E Do you wish to.claim Veteran's Preference? C1Yes.GKNo (Call for details) Have you had any disciplinary action from any employer including military? Yes &{No Ifyes, provide detalls below: Sock ial Security Number, 9. _ Have you ever been convicted of or pled guilty to,any criminal violation? C1Yes WRNo _ffyes,provide detalls below (Including juvenile expunged, sealed, and/or adjudication withheld): Date: Coutt location: 10. Listall employment begi Place inning wit Charge: Disposition: _ ant, including summer and part-time positions while attending, school for the past ten years. If unemployed for a period, set forth dates of unemployment, B [eikcaccks Dery Pine ees ad DatesWorked | Salary YourTitle ane Reason for Leaving Tolono Taoset Waples| fol=Pres_| Soo wk | owner n/a STi own beswess | JA Sota Gost ee led sfeis = oo] Hone el fier TiS ene the fl : Maples folise lef = woe [oyun |Potal Fine Stueiem | Rerwe | [Om Productions | era [78] 600%! Saks area teel| aera Suetnnee Glee- GJaal ars*ue| clerk — Aen | “Silat Continue, in above format, on separate sheet of paper 11, Resklences: List all residence addresses for the past ten years beginning with current address: adress ay state Dates From/To May. 03, Ava — Pres Noy ot, 2001-8 | ‘Apc 19 — Faly 19 Aer? - Ap 7 12. Driving History:You are not required to complete this question i applying for clerical position or any position that does not requite driving a vehicle. state where licensed:_FLA License Ne: List any trafic violation conviction including adjudication withheld within the past ten yeas. Provide date, charge, court location, and disposition: Mone 2 En fae Social Security Number. 2. Have you ever been dlmissed fromm 2 poston? __ves _ Kye b, Have you ever been asked to resign from a position? _Yes _7* No & Have you ever had any disciplinary action taken against you from any employment or position you have held? ___Yes e No If yes to any of the above questions, provide details: 3. Have you resigned or left 2 Job by mutual gareement following allegation of misconduct or unsatisfactory performance? Yes © No If yes, provide details: 4. List all law enforcement agencies (nat listed as an employer) where you have applied for a Position, performed paid services, or performed unpaid services; dates and results Nove 5. Uist all internal affairs investigations of which you have been the subject (agency, time, charge, outcome) and attach details, if available: ne See if a List all excessive force charges placed against you, if applicable: NEN ‘Section 3: Residences 1, List actual places of residence for the past 10 years starting with the most recent. Include all addresses including while at school and in military. For college on-campus residences, give dormitory name, city, and state, If residences in military service cannot be shown as street address, indicate complete military unit designation and location by city and state. If post office box, give actual street address and location of post office. Dates From/to | Address Tai Temp [State [May 02 Preiea?| 4 Hardie Wame : Phone with : area code PiPers Vrowe | Avepucl /vandebuit beh WD.) Mapes AR B9- 590-6554. Dates From/To TAddress Titw TCountv | State pSeby H— Many Landlord Nam& runs sone wi peti area code [PRS Gree Aucpurk 0 Javdecoalt H Wales | | 234-5 9006? ic | | | Section 3: Residences (cont’d) Social Security Number. Dales From/fo_[aaraee SFT RT 1 4 Gul lord Name 7 | mustess uy sre | none wit e ___| area code Dates From/To | Address : city County [State Landlord Name | Address City State | Phone with - 4 area code f List any additional addresses, using format above, on separate sheet of paper. Section 4: Military History Se co nt we rico ot iss stone nes i branch of Service: “Highest Rene Serial i: Duty Dates: From ff To__f._f_ From _j__/___ To__/__/. Date and type of discharge: _ ‘Are you now or have you ever been a member of a reserve unit or the National Guard? Yes NO = =n ee ia If Yes, state the branch of service, name and location of your unit and whether you attend drills, meetings, or camps: List any disciplinary actions: ist awards: __ ‘Are you eligible for re-enlistment?____Yes_No_ If no, provide details: ection 5: Personal References and Acquaintances. Social Security Number_. 1, Personal References: Give three (3) references (not relatives, former or present employers, significant others, or in-laws) viho are responsible adults of reputable standing in their ‘communities who have known you for at least the past three years, If reference Is retired, list former occupation. a. Compete Name Years | Homa adress | Wome phone with Occupation with Peta eee oat espace UPD IC Coury Aetie Nemes ne Poise. Dek _ Wesu-eqs b. ser Completa Name Years | Home sacra Wome phone with Gazupation with __|stown | induding cy/state | area ede business phone ‘lin jacst Safi Dave Merder. S, 3-70-49? Complete Name Years | Home address | Home phone with | Occupation with Known including city/state | area code business phone Phi varoveio | 5 _ Mepes folive z gAPU 2. Social Acquaintances: Give three (3) social acquaintances, other than those listed above, In your ‘own age group (including both sexes) who have known you well for the past five (5) years. a. Complete Name Years | Home address Home phone with | Occupation with _[ietonn | Tortctna cietate | ron code business phone DT. Carroll 56 ESD Sf fra i ; 23}- A3-1390 b. ‘Complete Name Years] Home address Home phone with | Occupation with Known | includina citv/state | area code. business phone Mike Nemes | test ean Me C2) F617?) ‘Complete Name Years ‘Home address, Home phone with [ Occupation with Known | including city/state | area code business phone, Dave Desesl) | & SC: fret Fal Gi) sy-192' Are you acquainted with any members of the Coilier County Sheriff's Office? If so, list name(s) x and Your relationship ty ead 7 an Sg Dawe Mande % TI_Ceccil Section 6: Narrative Section Social Security Number__ Expigin why the Coller County Sheriffs Ofce should offer you a poston; forcement, Kecenth, Explain why the Collier County Sheriff's Oftice position means_to you! : LT Cam do Sone byg Le. , TE Can _bearn’ anol evel! in afi he FE enw Et _ mens. idm Cocerc fore ; How did you learn about this vacancy (check only one): Print Ad (name of publication: _ =_Walk-in/Call-in Radio/TV Ad (station: de CCSO Jobs Hotline —~Agency Member: ‘Schoo! Announcement Criminal Justice Academy: __Hilitary Outplacement Internet Ad or Spode: ra ots ster reeeeeeeeseeeecececeseeeee _Y% other: Fats. thot ave tpl aa C680. 1. Are you a licensed florida. automobile aperator or chauffeur? _@ . Yes License Now Date of Expiration Restrictions:_ Ng v@_ ————— 2. Doygu now hold or have you ever held an operator or chauffeur license in another state? Yes No If yes, please provide state(s), license number, name used and approximate dates held. NY OL 3. Has your license ever been suspended or revoked? __ Yes__No IT yet, please provide complete detalls Including reason for suspension or revocation. i 4. st all tickets or traffic violation charges (excluding parking tickets) including date, charge, court location and disposition. Apo (987-% ae for Speaking a Section 8: Credit Data Social Security Number 3. Non-certified applicants go to Page 9 Do you hayg. any sources of Income other than your salary or the salary of your spouse? Yes No Specify each with an estimated annual amount. ‘Are you or your spouse indebted to anyone? _Yes No If yes, list all debts over $500. Be sure to Include student loans and charge accounts. Also, list any debt where payment is past due, regardless of amount. creditor ees Tait] Coan oF Reon ee An f ae F el Coreint Oy Acta ok Bespin v y Boe | we non nove | gue , Us /rov. Probe bay Behe) Fey | Have you, your spouse, or a company controlled by you filed for bankruptey? es) No Or declared bankruptcy? Yes __.No Or had a legal judgment rendered again you for a debt? ___Yes No If yes to any of these questions, provide details: Have your accounts ever been placed in the hands of a collection agency or reported as a “bad debt"? ? Yes lo If yes, give details: Do you or have you ever owned any stock or Interest in any firm, partnership or cosfteyation dealing wholly or partly in the sale or distribution of alcoholic beverages? __Yes\ No Are you now issued or have you ever been issued ¢ license to engage in a business or profession? Yes: No Faednge in hang Suleun ia PLA. Have you ever had a license (except driver's license) cancelled, suspended or revoked? —_Yes_G? no Do you own a business, or are you a partner or corporate officer in any business or organization not listed previously as a current or former employer?___Yes_ No If you answered "yes" to any of the above questions, please provide details including the type of license oF certificate, the agency that issued the license, effective date of license and license number. Section 10: Organization Membership Social Security Number __ 1. __List all clubs, societies, gangs which you are or have been a member as Nae City & State Former | Present (list position held and Niwe- describe activity) it ————! 2. Are you now of have you ever been a member of any foreign of domestic organization, association, movement, group or combination of persons which has adopted, or shows a policy of advocating or approving the commission of acts of force or violence to deny other ‘persons thelr fights under tha constitution of the United States by unconstitutional means? Yes No 3. Have you ever made a financial or other material copibution to any organization of the type described In question #2 above? ___ Yes No 4. At the time of your membership, participation, seycontribution, did you know of any unlawful aims of the organization? Yes’ (2 No 5. Did you Intend to promote any unlawful aims of the organization? ved). No If you answered yes to any of the questions above numbers 2 through 5, explain your participation including name of organization, date, and location. pee None ae 1, Have you ever been arrested, charggthor received a notice or summons to appear for any criminal violation? Yes No If yes, please provide details below: List all such matters even if not formally charged, or no court appearance, or found not guilty, or nolo contendre to any charge for which adjudication was withheld, or matter settled by payment of fine or forfeiture of collateral. (Include alll juvenile record(s) or records which have been sealed/expunged) Date | Place & Dept. Charge Court & Location’ Disposition | 2, To your knowledge, has any member of your family ever been arrested for other than traffic violations? Yes No If yes, please provide details below: Date | Place & Dept. Charge Court & Location Disposition Backaround Screening Disclosure Affidavit Social Security Number. The Collier County Sheriffs Office screens prospective members, including volunteers, to evaluate whether an applicant poses a risk of harm to the children, youth, and citizens it serves, Information obtained is not an automatic barrier to appointment to position, however, the information is considered In view of all relevant circumstances. This disclosure is required to be completed by all applicants who receive a conditional offer of appointment. Any falsification, misrepresentation, or incompleteness of this disclosure form Is grounds for disqualification or termination. Initial answer under "yes" or “no” and provide brief explanation for a “yes” answer in the "Explanation" section. Identify "yes" answer by number. Questions apply to your entire life -- whether as an adult or a juvenite and whether sealed or expunged, Thave been convicted of: Yes No 1. a felony. 2. rape or other sexual assault, 3. drug or alcohol offenses. 4, abuse of a minor or child, whether physical or sexual. 5. incest: 6. kidnapping, false Imprisonment, or abduction. 7. sexual harassment, 8. sexual exploitation of a minor. 9. sexual conduct with a minor. 10, annoying/motesting a child, 11. lewdness and/or indecent exposure. 12, lewd and lascivious behavior, 13, obscene literature. : 14, assault, battery, or other offense involving a minor. 15, endangerment of a child 16. any misdemeanor or other offense classification involving a minor or to which @ minor was @ witness. 17. unfitness as a parent or custodian, 18, removing children from a State or concealing children in violation of a faw or court order. 19, restrictions or limitations on contact or visitation with children or minors. 20, domestic violence -- any family member or significant other. 21. accusation of any of the above. 22. any misdemeanor involving false statement under oath or in official capacity. FRPP HPS Reiss RL beh bahche Resigned under threat of termination of employment or volunteer work for: No. 23. sexual harassment. 24. drug or alcohol-related offenses. 25. use of force. 26. excessive absenteeism or tardiness, 27. theft. 28, threatening a co-worker or supervisor. Hlllié Ph bss Pleaded gulity to (whether or not resulting in a conviction) or nolo contendere or no contest to: Yes 29, any felony. 30. rape or other sexual assault. 31. drug or alcohol offenses. 32. abuse of @ minor or child, whether physical or sexual. 33. incest. 34. kidnapping, false imprisonment, or abduction. 35, sexual harassment, 36, sexual exploitation of a minor, 37. sexual conduct with a minor. 38. annoying/molesting a child. 39, lewdness and/or indecent exposure. 40, lewd and lascivious behavior. 41. obscene literature. 42, assault, battery, or other offense involving a minor. 43, endangerment of a child 44, any misdemeanor or other offense classification involving a minor or to which 2 minor was a witness. 45. unfitness as a parent or custodian. 46. removing children from a State or concealing children in violation of a law or court order. 47. restrictions or limitations on contact or visitation with children or minors. 48. domestic violence -- any family member or significant other. 49. accusation of any of the above. 50, any misdemeanor involving false statement under oath or in official capacity, 7 Seer | | Hl PASI Bix ARK RK ei pepete z Explanation Section: If you answered "yes" to any of the above, please explain. Refer to question number. Question Number Description (include dates) 10 Personal Inquiry Waiver Authority for Release of Information To: Concerned Person or Applicants Name:, Dan) thes ), Authorized Representative of Any Organization, Institution Date of Birth: ae or Repository of Records Social Security Number: T respectfully request and authorize you to furnish the Collier County Sheriff's Office any and all information that you may have concerning my employment and pre-employment records, Internal Affairs investigations, school record, military record, criminal investigations, reputation, and financial, credit status, background reports and polygraph examinations. All medical information will be requested post conditional offer. I authorize medical care provider to release information for the purpose of determining fitness for duty. Please include any and all reports including all information of a confidential or privileged nature, and photostats of same, if requested. This information is to be used to assist in determining my qualifications and fitness for the position 1 am seeking with the Collier County Sheriff's Office. I hereby release you, your organization or others from any liability or damage which may result from furnishing the information requested above. Must be signed in the presence of a Notary Public. Chil Waefp MSY “Applicants Signayrd SLOW Ser Piny BOBS. ee a Lyle. fe State Sig Affidavit State of Florida County of Collier Subscribed and sworn to (or affirmed) before me on_V VL AOR by Dal S RoR anPor appieanny. He or she is personally known to me or has presented _* Title: Notary Public Commission Number: Expires: 11 Applicant Certification My appointment or employment will be contingent upon the results of a complete background investigation. Any omission, falsification, mistepresentation on this background packet will be the basis for my disqualification as an applicant or my dismissal from the Collier County Sheriff's Office, | consent to a polygraph examination conceming the truthfulness of my responses to the information requested on the application and background information, any physical examination, psychological examination, or drug test. 1 will be fingerprinted. My employment or appointment willbe contingent upon the results of a complete drug test. | will be roquired to take drug tests during the term of my employment or appointment with the CCSO. The use of drugs or alcohol is not permitted during work or duty time, whether paid or unpaid, in the areas (including vehicles) where work is performed, Continued employment or appointment may be contingent upon the results of medical or psychological examinations that | may be required to fake during the term of my employment or appointment and the maintenance of personal Physical fitness, to the degree necessary, to perform satisfactoriy the essential functions of my position or assignment. Any employment or appointment offered to me will be contingent upon my acoeptance of compensatory time off, instead ‘of cash, in payment for overtime hours that | work, to the extent allowed by law. The Sherif has the absolute discretion to substitute cash periodically, in whole or part, for accrued compensatory time, The following types of information will be collected during the appointment process: employment znd education Histories; medical, miftary, insurance, credit and financial information; motor vehiole and police records; information about my abilties, family, character, lifestyle, and organization memberships. Information will be obtained by letter, by telephone, and by personel interview with both primary and secondary sources. | may be required to fumish the CCSO with @ copy of my Income Tax Retum for the year preceding this application and each year during my employment or appointment. This information is used as one element for appointment or employment decsions, | authorize any of the persons or organizations referenced in my application and background packet to fumish information, personal and otherwise, regarding my ability and fess for appointment fo a position wth the CSO, | relieve all such parties from any and alt liability for any damage that might result from furnishing such information to the ccso. | agree to conform tothe rules, regulations and orders of the CCSO and acknowiedge that such rues, regulations and orders may be changed, interpreted, withdrawn or added to by the CCSO, at its discretion, at any time and without any prior notice to me. Ths form shall become the property of the CCSO and it, andthe information received in response fo the background investigation, are subject to Florida's public record laws and possible disclosure, | understand and agree to the above conditions and cert that all statements made by me on this background packet and application are true, corrct and complete, to the best of my knowledge, | understand that my obligation to provide information is confining in nature and that any chenges, additions, deletions, ‘or corrections inthe information provided shall be submitted as soon as ansible LAr QMonarn A tefrfoe ‘Signatur witossed ob Se ovahio® 12 / } Date Received lo [k2 olive LEE COUNTY SHERIFF’S OFFICE EMPLOYMENT APPLICATION FORM The Sheriff's Office is an Uqual Employment Opportunity Employer. We consider applicants for all positions without regerd {to race, color, national origin, sex, age, disability, marital status, religion or any other legally protected status, NOTICE: Please provide originals of the following documents: . Valid Florida Driver’s License 7. Military discharge (s) and all DD-214"s . Social Security Card 8, Sclective Service Card (if applicable) Birth Certificate (fiom Vital Statisties) 9. IELE/CO cettified, copies of certification . High School Diploma or G.E.D. 10. Official college transeripts (if applicable) . Proof of macriage(s), divoree(s) or 11, Original naturalization papers (if adoption applicable) Al Florida vehicle registeation (5) in 12, Passport (if applicable) applicant's name POSITION APPLYING FOR: [Deputy Sheriff C1 Corrections Clerks (1 Correctional Officer (C) Communications/Dispatch/911 [J Law Enforcement Sponsorship Cicommunity Service Aide (7) Corrections' Academy Sponsorship (Davxiliary Deputy Dother eeeieeeeeaela INSTRUCTIONS Application must be handwritten legibly in ink or typed by the applicant. All questions must be answered, If ‘space provided is not sufficient for complete answers or if you wish to furnish additional information, attach sheets of the same size as this application and number answers to correspond with questions, Tunderstand that the submission of this application does not constitute acceptance of employment or appointment with the Lee County Sheriff's Office. Moreover, I understand the Lee County Sherifi's Office is under no obligation to sponsor me as a candidate for any law enforcement treining program, PERSONAL HISTORY 1, Full Name Maecewo CAeMiNE o Te ~ Last Name Fit “Middle ‘Suffix circumstances and time petiods you used them. (For example: 2. Other: Listall other names you have used vikname(s) maiden name, former name(s), alias(es), 0 Dates From Dates To Name Month/Year _| Month/Year 3, Date and Place of Birth: Gy Camiy | Sate Countsy no USA) Bean, Wy 4, Are you a United States citizen? IX] Yes []No If naturalized, please provide: Page 1 i ) = me — cout Nataraliaton No, 5. Mavital Status: ] Mansied [1] Divorced [J Separated [] Widowed [X[ Never Married 6. Applicant's Current Address and Phone Number [ Adavess: | Hom 1. Applican’s Secs! Secwriy Kc? cc | Spouse's Name, Address and Phone Number: ‘States ip: Home Phone? 9. Children’s Names and Ages: Name ‘Aaavess 10, Former Spouse(s) Name and Address and Phone Number: Names ‘adresse city: Hone Phone: 11, Ate you currently related to any person employed by the Lee County Sheriff's Office? (] Yes {XJNo If, yes please provide names (5) and current position held. [States Zip: 12. Are you now able to participate with or without accommodation in defensive tactics, itearins, physical tr operation of a motor vebiole, or otherwise perform the duties set forth in the job description of the position for which you applied? [X] Yes [] No n is required, would you need special 13, This position may require a physical agility test. If such a test or examinat accommodations to perform the agility test? [] Yes No 14, Explain what accommodation(s) you would need to petform these tasks or take the fest/examination. N)h Page 2 ARRESTHISTORY/COUREDATA — (G/pyoy_ in 1989) 1, Have you ever been arrested, charged or received « notice or summons to appear for any criminal violation, — rogardloss if the record was sealed or expunged? FX] Yes []No Gppr: Ase 17 fickeT for Pues oF 2, Have you ever received a ticket or been charged with a traffic violation (excluding parking tiokets)? Bal Yes [No 3. Toyour knowledge, has any member of your family ever beon arrested for anything other than traffic violations? If yes to question #1, #2, of #3, list all such matters even ift © You wete not formally charged; ‘You had no court appearaices ‘You were found not guilty; You pleaded nolo contencre to any cherge for which adjudication was withheld or ‘The matter was settled by payment of fine or Forfeiture of collatoral, uclude your juvenile record and records of your arrest(s), which have been sealed, if any). eeee Date Place & Department Charge Court & Place Dkposkion AeA Lgetor) | SUF PLE Co | Pus abdul Sufi Dasosscl- Relatives Name_ Place & Department ch Court & Place Disposition Provide details foreach response to questions #1, #2, or #3:_Appr,AB7~1990_ Speeds of Florida z : fiket 1 shebe n? L] Yes EX]No ‘ Geert ‘Hass any law enforcement officer ever detained you for investigative purposes? (1 Yes IJNo= eu Soe " 6. ‘Toyour knowledge, have you ever been, oF are you now the subject of, or a suspect in, any oriminal investigation? C¥es Dan 7. Have you ever been fingerprinted for any reason (arrest, job application, military, etc.)? [XJ Yes []No Tyos to questions #4, #5, #6, please provide details, Finger prinhed Ge Law Enfaccenest Sébo's 4, Blave you or your spouse ever been a plaintiff or defendant in a civil BUSINESS INTERESTS AND LICENSES Do you or have you ever owned! any stock or interest in any firm, partnership, or corporation dealing wholly or pattly in the sale or distribution of alecholic beverages or pawn shops? [_] Yes [34 No 2, Ave you now issued or have you ever been issted a license to engage in a business or profession? [XM Yes [] No ion not listed previously 3. Do you own a business or are you a partner or corporate officer in any business or organi: ‘asa ouirent or former employer? fx] Yes L] No 4, Vlas your license ever cancelled, suspended, or revoked? [_] Yes TXLNo Ifyes t» question #1, #2, or #3, please provide details including the type of license or certificate, the agency that issued the license, effective date and license number. “Tye of LlcensolCaricale Tesulng Agensy festive Date Ticense Namber—] re leh weepaat | Shale of Ftucidm aleol wir 1636 i] Redeslale Cicer hele wf Ptordn (Approx A006) SLIC1G34 p,y EMPLOYMENT HISTORY ‘Starting with your erent employer, please list al previous employers, tom the age of eighteen (18). IF unemployed for period of time, sot forth dates of unemployment. Ifthe aplicat doesnot wish for us to contac the current employer, please note in te mergin “DONOT CONTACT." It will be necessary to contact your curent employer When it comes tine to-do your final background investigation Dates Work ‘Month/Year Your | Nameot | Reason for Name & Address of Employer | trom To | Salary_| viterPosiion |_supervisor_|_"Lenving [Mane Aiecaticle's Dairy —_]

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