Exhibit_5_LAUTENBERG_STATEMENT.pdf

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Armed Security Guard Services for DOT
Solicitation number
693JK425R500004
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The document is a Lautenberg Statement form related to a federal contract for Armed Security Guard Services. The form implements Public Law 104-208, which prohibits individuals convicted of misdemeanor domestic violence from possessing firearms or ammunition. As part of the contract requirements, potential contract employees must disclose any such convictions, as they would be disqualified from performing as an armed contract employee. The form requires individuals to certify whether they have been convicted of a misdemeanor domestic violence crime, with a warning that providing false information could result in adverse action or criminal prosecution under 18 U.S.C. §1001.

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EXHIBIT 5

LAUTENBERG STATEMENT

Public Law 104-208 & Title 18 USC Sections 921, 922 and 925

1. Public Law 104-208 has amended Title 18, United States Code, Sections

921, 922 and 925, making unlawful for any person convicted of a misdemeanor crime of domestic violence (spouse abuse, parent abuse, child abuse, etc.) to ship, transport, possess, or receive firearms or ammunition. Presently, there are no exceptions or time limits included in this law.

2. Therefore, anyone ever convicted of the subject crime(s) would be affected by its provisions. Since a person convicted of a misdemeanor crime of domestic violence can NOT possess a firearm or ammunition, such a person may NOT perform as an armed Contract employee.

3a. Have you ever been convicted of a misdemeanor crime of domestic violence, as defined by 18 U.S.C. §921(a)(33)?

YES__________ NO ____________

3b. If you answered YES, provide the following information with respect to each conviction:

a. Court/Jurisdiction:

b. Docket/Case Number:

c. Statute/Charge:

d. Date Sentenced:

3c. I certify that, to the best of my information and belief, all of the information provided by me here is true, correct, current, complete and made in good faith. I understand that false or fraudulent information provided herein may be grounds for adverse action, up to and including removal, and is also criminally punishable pursuant to Federal law, including 18 U.S.C.

§1001.

Signature: __________________________________ Date Signed: ___________

Name: ____________________________________

(Print your complete legal name)

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