Contractor Pre-Employment Form.pdf
PDF 32 KB Posted
- Attached to
- Y-Contruction - Electrical Work
- Solicitation number
- RFPX000580
- Issued by
-
Department of Justice Bureau of Prisons
About this file
Contractor Pre-Emp Form
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Text version
FEDERAL BUREAU OF PRISONS
CONTRACTOR PRE-EMPLOYMENT FORM
NAME:
ADDRESS:
SOCIAL SECURITY NUMBER:
Do you know or are you related to anyone who is an inmate in this or any other correctional institution? _____Yes _____No
If yes, please provide names, locations, relationships, and describe any contact with the inmate(s).
Are there any criminal charges pending against you? _____Yes _____No
If so, please provide charge, date arrested, court dates, docket numbers and any other pertinent details.
Are you now or have you ever been incarcerated or under correctional supervision (including home confinement, probation, work release, etc.)?
_____Yes _____No
If so, please provide dates of incarceration, sentence, location, charges, status, and any other pertinent details.
CERTIFICATION: I certify that all statements made on these pages are true, complete, and correct to the best of my knowledge and belief and are made in good faith.
Signature (sign in ink) Date
File details come from the government source that posted it. Updated .