| Answer the following questions by checking either "Yes" or "No" |
Yes
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No
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| 1. Are you a citizen of the United States? |
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| 2. If answer to question 1 is "No", are you a legal permanent resident of the United States in possession of a current alien registration card? |
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| 3. Except for minor traffic infractions, have you ever been convicted of a misdemeanor or felony in this state or elsewhere? |
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| 4. a) Has any Private Investigator, Bail Enforcement Agent, or Watch, Guard. or Patrol Agency licence issued to you or to a partnership or corporation, of which you were a member or officer, ever been revoked in this state or elsewhere? |
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| 4. b) Has any application submitted by you for licence as Private Investigator, Bail Enforcement Agent, or Watch, Guard. or Patrol Agency ever been denied by this state or any other governmental or regulatory body or office in this state or elsewhere? |
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| 5. Has any licence or permit issued to you or applied for by you ever been denied, suspended, or revoked by this state or any other governmental or regulatory body or office in this state or elsewhere? |
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| 6. Are you presently under indictment for any crime or offense in this state or elsewhere? |
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| 7. Is there any complaint against you now pending before any department, bureau, board, prosecuting officer, criminal court or any other governmental or regulatorybody or office in this state or elsewhere? |
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8. If answer 3 to 7 inclusive is "Yes", explain fully, setting forth details for each such answer:
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9. Have you been dismissed from any employment for any reason other than lack of work?
If "Yes", please give dates, nature, place of such employment, name and address of employer(s) and reason(s) for such dismissal.
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