Bermuda Police - Criminal Records Application Form SF39_Informational Purposes only_do not complete until after award of contract (2).pdf

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Attached to
Landscaping, Hamilton, Bermuda
Solicitation number
19UK5624Q0051
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About this file

This document is a Police Records Check and Release Form (SF39) that is used for informational purposes only and should not be completed until after award of a contract. The form is submitted to the Bermuda Police Service to authorize the disclosure of any previous convictions. The form collects the applicant's personal information, including full name, any other name, age, gender, date of birth, country of birth, current address, telephone numbers, and email address. It also includes a section to authorize a third party to act on the applicant's behalf. The form is related to the federal contract opportunity for landscaping services at the U.S. Consulate General's residence in Bermuda, Solicitation Number 19UK5624Q0051. This contract will be awarded to the lowest priced technically acceptable offeror who is a responsible contractor.

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Text version

Police Records Check and Release Form (SF39)

SF39 - Police Records Check and Release Form | All clearance certificates issued in accordance with the Bermuda Rehabilitation of Offenders Act 1977

Please submit this form only to Police Vetting Section (CRO), Dame Lois Browne-Evans Building, 58 Court Street, Hamilton, Bermuda. Opening hours: 9:00am – 4:00pm (closed 1:00pm – 2:15pm) Mon-Fri | Email: vetting@bps.bm

Section 1 Instructions: Complete all relevant fields and follow the submitting instructions as outlined in the Guidance Notes.

Full Name

Any Other Name (i.e. Maiden or Deed Poll)

Age Gender

Date of Birth Country of Birth

Current Address

Telephone Numbers (w) (h) (c)

Email address

*Full Name and Address of recipient

Reference Number (if applicable)

Reason for Application

*I authorize the Bermuda Police Service to disclose details of my previous convictions (if any) to the recipient named above.

Section 2

I authorize the person listed below to act on my behalf in this matter.

I authorize

Contact Number(s)

Signature: _____________________________________________ Date: ______________________

Declaration: I, herewith, confirm that to the best of my knowledge, the above information is true and accurate. I also confirm that I have read all Guidance Notes

Collection / Return Option for completed forms mailto:vetting@bps.bm

Section 1
Section 2
Gender: [ ]
Reason For Application: [ ]
Full Name:
Age:
Country of Birth:
Current Address:
Full Name and Address of Recipient:
Reference Number:
Authorization:
Contact Number 1:
Contact Number 2:
Other Name:
Reason for Application (Other):
Collection options: [ ]
Todays Date:
Work Number:
Home Number:
Cell Number:
Email Address:
DOB:

File details come from the government source that posted it. Updated .