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FDLE
AFFIDAVIT OF APPLICANT
Florida Deparment of
Un Enforcement Incorporated by Refrence in Rule 118-27 02(0)(9, FAC. :
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Lan Four Dg et appa Soc Seay Maer
opcants Legation: TTENy GREGORY
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Us this fom ety your complance wih the Seyi regulments of Seton 913.13, F.S. fy undrtand tte gly er employer a a ew eon cacao
ceeional pon oer, shal amp) wit be log prods of Secten 4313.68
Beatin 2 yeas ge tet corsctora fics prmarioa. S(t }.F.5° shal nab dbl fer eplat or ppoent san cer, citsandg person
bs esrmaeaesian saat Eta cammes ccc lod
S egenieaeets ++ rebeigentiiedy te epg gee :
: + repose apc eaatany ose neta set pein le
+ Wet i on ca ny yo a misererr Inohing sdy orse
‘ater. y paso ler 1,18, poe gay ora cemmgne ware THBZTERRINAL FAC,
fry aye dando eg pf ae stone + ecgzasmanl esate
Hava reechodecahronbi aerefonthe USM,
‘ue Falto NA Ination, atest tothe flown stent Ech samen sale chacd “Tru alse or MA"
go +. anid yeep STB ol ce rd al ae Emin
grain corn why pate coe
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of “4. Thad criminal roc sald or pgs
og der essen by a tam rl gy rn cn i srr weg Base as edb
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of ‘lpr sevedin fe US. any.
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go 7 Ta crac aa si ca ies cea i ca Be PRS HST
Law nocnet C.conztont concn baton
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[Lew Esforanent, C.cometonat C1 cormctiona Probation
[ROTICE! The doa si conte sa ol tone va pinoy ol Secon SOIR FS, arab Ai aca he enoofng ope abe CTS
‘Sencar an Ting Constr. Any etal oman wen sng bs plan ore exe cl he a el Gnas a encarta dae od
_Sequiy a et loner as 38 oer,
PEASE READCATEULL BEFORE ENG, Yu esi tt ont rea act pe, pn nin yagi en aay ae
oe SES ce vege, ney cual et inet cl obiveaken ta ne ememase
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“NOTE: Private Corectonal ites ust submit orginal and shal fward Ge completed afidavlwaphd fo te Regievation of Employmara, Afdavi ol Camplance
Form C1STC-60 to FOLE riinal Justice Professionlsm Program, Pst Ofce Box 149, Tallahassee, Faia 220249, Atention Records Sacton
‘ieied THN Orginal“ Agency Copy FDLE Tore ‘Comnssion Approved Revers: BOTT
Form Effective Dale: 82018.
TTAARAN. CLIFFORD
es he, 202 |
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