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Outline

The Texas Personal History Statement form is an essential document for individuals seeking licensure as peace officers or jailers in Texas. This form requires applicants to provide comprehensive personal information, including their full name, contact details, and physical description. Additionally, it includes sections where applicants must disclose their educational background, previous law enforcement applications, and family details. Before filling out the form, applicants must confirm they meet specific eligibility criteria, such as citizenship, education, and a clean legal record over the past decade. Notably, the form emphasizes the importance of honesty; any deliberate misstatements or omissions can lead to disqualification. Furthermore, it safeguards applicants' medical privacy by stating that they are not required to disclose any medical conditions until a conditional job offer is made. Completing the Texas Personal History Statement accurately and thoroughly is crucial, as it serves as a key part of the background investigation process for potential law enforcement candidates.

Sample - Texas Personal History Statement Form

DP-1

THE UNIVERSITY OF TEXAS SYSTEM POLICE

PERSONAL HISTORY STATEMENT

APPLICANT NAME

POSITION

Date Issued:

 

Return By:

 

Received On:

Received By:

9.14.11 MT

PERSONAL HISTORY STATEMENT for TEXAS LICENSURE

Instructions to the Applicant

Before you begin to fill out this personal history statement, please ensure that you meet the following requirements. You must meet all five of these requirements to qualify for licensure as a peace officer or jailer in Texas.

I am a citizen of the United States of America.

I have earned a high school diploma or a GED.

I have never been convicted, pleaded guilty to (nolo contendere), nor have I been on court-ordered community service/probation or deferred adjudication for a Class A misdemeanor or a felony.

During the last ten (10) years, I have not been convicted, pleaded guilty to (nolo contendere), been on community service/probation or deferred adjudication for a Class B misdemeanor in this state, other state, or while serving in the military.

I have never had a military court martial that resulted in a dishonorable or bad conduct discharge.

DISQUALIFICATION

There are very few automatic conditions for rejection. Even issues of prior misconduct, employee terminations, and arrests are

usually not, in and of themselves, automatically disqualifying. However, deliberate misstatements or omissions can and often will

result in your application being rejected, regardless of the nature or reason for the misstatements/omissions. In fact, the number one reason individuals “fail” background investigations is because they deliberately withhold or misrepresent job-relevant

information from their prospective employer.

This personal history statement is a governmental document. Be truthful, as there are criminal consequences for being untruthful on a governmental document.

Once you begin:

Type or neatly print, in ink, responses to all items and questions. If a question does not apply to you, write “N/A”

(not applicable) in the space provided for your response. If you cannot obtain or remember certain information, indicate so in your response.

If you need more space for any response, use the last page of this form (page 27) and identify the additional information by the question number.

Be as complete, honest and specific as possible in your responses.

Disclosure of Medically-Related Information

In accordance with the U.S. Americans with Disabilities Act, at this stage of the hiring process applicants are not expected or required to reveal any medical or other disability-related information about themselves in response to questions on this form, or to any other inquiry made prior to receiving a conditional offer of employment.

9.14.11 MT

Initial this page to indicate that you have provided complete and accurate information: _____

PERSONAL HISTORY STATEMENT for TEXAS LICENSURE

SECTION 1: PERSONAL

1. YOUR FULL NAME

1. YOUR FULL NAME

1. YOUR FULL NAME

LAST

FIRST

MIDDLE

2.OTHER NAMES, INCLUDING NICKNAMES, YOU HAVE USED OR BEEN KNOWN BY

3.ADDRESS WHERE YOU RESIDE

NUMBER / STREET

APT / UNIT

CITY

STATE ZIP

4.MAILING ADDRESS, IF DIFFERENT FROM ABOVE

5.CONTACT NUMBERS

 

HOME (

)

 

WORK (

)

EXT

OTHER (

)

CELL

FAX

 

 

 

 

 

 

 

 

 

 

6.

EMAIL ADDRESS

 

 

 

 

 

 

 

 

HOME

 

 

 

 

 

BUSINESS

 

 

 

 

 

 

 

 

 

 

7.

BIRTH PLACE

(CITY / COUNTY / STATE / COUNTRY)

 

 

8. BIRTHDATE

9. SOCIAL SECURITY #

 

 

 

 

 

 

 

 

 

 

10. DRIVER’S LICENSE

 

 

NO.

STATE

EXP

11. PHYSICAL DESCRIPTION

 

HT.

WT.

HAIR COLOR

EYE COLOR

12. Have you ever attended a basic licensing course?

Yes No

 

 

 

 

 

 

If yes, provide the following information: PID:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A)

ACADEMY NAME

 

 

 

FROM

TO

DID YOU GRADUATE?

 

 

 

 

 

 

 

 

 

Yes

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

LOCATION

(CITY / STATE)

 

NAME OF TRAINING OFFICER / ACADEMY

CONTACT NUMBER

 

 

 

 

 

COORDINATOR

 

 

 

(

)

 

 

 

 

 

 

 

 

 

 

B)

ACADEMY NAME

 

 

 

FROM

TO

DID YOU GRADUATE?

 

 

 

 

 

 

 

 

 

Yes

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LOCATION

(CITY / STATE)

 

NAME OF TRAINING OFFICER / ACADEMY

 

CONTACT NUMBER

 

 

 

 

 

COORDINATOR

 

 

 

(

)

 

 

 

 

 

 

 

 

 

 

 

 

 

13.Have you ever applied to any other law enforcement agency in the last ten years (city, county, state or federal)?...

Yes

No

If yes, list ALL agencies you have applied to, starting with the most recent (give complete and accurate addresses).

All agencies MUST be listed regardless of the outcome or current status. Check all boxes that apply for each agency.

If more space is needed, continue your response on page 27.

A) NAME OF AGENCY

DATE APPLIED

 

 

ADDRESS (NUMBER / STREET)

BACKGROUND INVESTIGATOR’S NAME (IF KNOWN)

CITY

 

 

 

 

ZIP

 

CONTACT NUMBER

 

EXT

 

 

 

 

STAT

 

 

(

)

 

 

 

POSITION APPLIED FOR

 

 

 

 

 

 

EMAIL

 

 

 

 

 

 

 

 

 

 

Check each step in the process that you completed, and your status:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STEPS:

Application

Written

Physical agility

Oral

Polygraph/CVSA

Background

Chief’s oral

Conditional job offer

 

 

 

 

 

 

 

 

 

 

STATUS:

Hired

On List

Withdrawn

Disqualified

 

 

 

 

9.14.11 MT

Initial this page to indicate that you have provided complete and accurate information: _____

PERSONAL HISTORY STATEMENT for TEXAS LICENSURE

13. Have you ever applied to any other law enforcement agency… continued

B) NAME OF AGENCY

DATE APPLIED

ADDRESS (NUMBER / STREET)

 

 

BACKGROUND INVESTIGATOR’S NAME (IF

 

 

 

KNOWN)

 

 

CITY

 

ZIP

CONTACT NUMBER

 

EXT

 

 

 

STAT

 

(

)

 

 

POSITION APPLIED FOR

 

 

EMAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Check each step in the process that you completed, and your status:

 

 

STEPS:

Application

Written

Physical agility

Oral

Polygraph/CVSA

Background

Chief’s oral

 

 

Conditional job offer

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STATUS:

 

Hired

On List

Withdrawn

Disqualified

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C) NAME OF AGENCY

 

 

 

 

 

 

 

 

DATE APPLIED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS

 

(NUMBER / STREET)

 

 

 

 

 

 

BACKGROUND INVESTIGATOR’S NAME (IF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

KNOWN)

 

 

 

 

 

 

CITY

 

 

 

 

 

ZIP

 

CONTACT NUMBER

 

EXT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STAT

 

 

 

(

)

 

 

 

 

 

 

POSITION APPLIED FOR

 

 

 

 

 

 

 

EMAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Check each

step in the process that you completed, and your status:

 

 

 

 

 

 

 

 

 

 

STEPS:

Application

Written

Physical agility

Oral

Polygraph/CVSA

Background

Chief’s oral

 

 

 

Conditional job offer

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STATUS:

 

Hired

On List

Withdrawn

Disqualified

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION 2: RELATIVES AND REFERENCES

14.IMMEDIATE FAMILY

Provide all applicable information in the spaces below.

Mark “N/A” if a category is not applicable or if the individual is deceased.

If more space is needed, continue your response on page 27.

N/A A. Father

NAME

HOME ADDRESS

(NUMBER / STREET / APT)

CITY

STATE

ZIP

 

 

 

 

 

 

HOME PHONE

WORK ADDRESS

(NUMBER / STREET / APT)

CITY

STATE

ZIP

()

 

 

WORK PHONE

CELL PHONE

 

EMAIL

 

 

 

(

)

 

(

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

N/A

 

 

 

 

 

 

 

 

 

B. Step-father

 

 

 

 

 

 

 

 

NAME

 

 

HOME ADDRESS

(NUMBER / STREET / APT)

CITY

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

HOME PHONE

WORK ADDRESS

(NUMBER / STREET / APT)

CITY

STATE

ZIP

 

(

)

 

 

 

 

 

 

 

 

 

 

WORK PHONE

CELL PHONE

 

EMAIL

 

 

 

 

(

)

 

(

)

 

 

 

 

 

9.14.11 MT

Initial this page to indicate that you have provided complete and accurate information: _____

Form Information

Fact Name Description
Governing Law The Texas Personal History Statement is governed by the Texas Occupations Code, Chapter 1701, which outlines the requirements for peace officer and jailer licensure.
Applicant Requirements Applicants must be U.S. citizens, have a high school diploma or GED, and meet certain legal and military history criteria.
Criminal History Disclosure Applicants must disclose any criminal convictions, including misdemeanors, within the last ten years.
Automatic Disqualifications While there are few automatic disqualifications, deliberate misstatements or omissions can lead to rejection of the application.
Medical Disclosure Under the Americans with Disabilities Act, applicants are not required to disclose medical information until a conditional job offer is made.
Application Format The form must be filled out neatly, either typed or printed in ink, with "N/A" used for questions that do not apply.
Additional Information If more space is needed for answers, applicants can use the last page of the form to provide additional details.
Initial Verification Applicants must initial specific pages to confirm that the information provided is complete and accurate.
Background Investigation Background checks are a critical part of the hiring process, and applicants must list all law enforcement agencies they have applied to in the last ten years.
Family Information The form requires detailed information about immediate family members, including names, addresses, and contact information.

Detailed Guide for Filling Out Texas Personal History Statement

Filling out the Texas Personal History Statement is an important step in the process of applying for licensure as a peace officer or jailer in Texas. It requires accurate and complete information about your personal history, background, and qualifications. Follow these steps to ensure that you fill out the form correctly.

  1. Read through the requirements to confirm you meet all five criteria for licensure.
  2. Gather necessary documents and information, such as your Social Security number, addresses, and contact numbers.
  3. Type or neatly print your responses on the form. Use blue or black ink if filling it out by hand.
  4. Begin with Section 1: Personal Information. Fill in your full name, including any other names you have used.
  5. Provide your current address and mailing address, if different.
  6. Include your contact numbers, including home, work, and cell phone numbers.
  7. Enter your email address and details about your birth, including the place and date.
  8. Fill in your Social Security number and driver's license information.
  9. Complete your physical description, including height, weight, hair color, and eye color.
  10. Answer questions about any basic licensing courses you have attended, providing details if applicable.
  11. List any law enforcement agencies you have applied to in the last ten years, including their addresses and your application status.
  12. Move to Section 2: Relatives and References. Provide information about your immediate family members, including their names, addresses, and contact information.
  13. If any category does not apply to you, write "N/A" in the space provided.
  14. For each family member, indicate if there has been any restraining or stay-away order in effect.
  15. If you need more space for any section, use the last page of the form and reference the question number.
  16. Initial the designated area to confirm that all information provided is complete and accurate.
  17. Review the entire form for any errors or missing information before submitting it.
  18. Submit the completed form by the specified deadline.

Obtain Answers on Texas Personal History Statement

  1. What is the Texas Personal History Statement form?

    The Texas Personal History Statement form is a document required for individuals seeking licensure as peace officers or jailers in Texas. It collects essential personal information, including educational background, employment history, and any relevant legal issues. Completing this form accurately is crucial for the licensure process.

  2. What are the eligibility requirements for filling out the form?

    Applicants must meet five key requirements to qualify for licensure:

    • Must be a citizen of the United States.
    • Must have earned a high school diploma or GED.
    • Must not have any felony convictions or Class A misdemeanors.
    • Must not have been convicted of a Class B misdemeanor in the last ten years.
    • Must not have received a dishonorable or bad conduct discharge from military service.
  3. What happens if I provide false information on the form?

    Providing false information can lead to serious consequences. Misstatements or omissions may result in the rejection of your application. This is particularly critical because the form is a governmental document, and dishonesty can lead to criminal charges.

  4. How should I fill out the form?

    Applicants should type or neatly print their responses in ink. If a question does not apply, it is acceptable to write "N/A." If additional space is needed, applicants can continue their answers on the last page of the form, clearly identifying the question number.

  5. Is there any medical information I need to disclose?

    At this stage of the hiring process, applicants are not required to disclose any medical or disability-related information. This is in accordance with the Americans with Disabilities Act. Such disclosures are only necessary after receiving a conditional offer of employment.

  6. What information is required about my family and references?

    Applicants must provide detailed information about their immediate family, including names, addresses, and contact information. This section also includes inquiries about any restraining orders involving family members. If a category does not apply, marking it as "N/A" is acceptable.

  7. What should I do if I have applied to other law enforcement agencies?

    If you have applied to other law enforcement agencies within the last ten years, you must list all agencies, regardless of the outcome. This includes providing complete addresses and any relevant details about the application process.

Common mistakes

Filling out the Texas Personal History Statement form can be a crucial step in your journey to becoming a licensed peace officer or jailer. However, many applicants make common mistakes that can jeopardize their chances of approval. Here are five mistakes to watch out for.

One of the most frequent errors is failing to provide complete and accurate information. When applicants skip questions or leave sections blank, it raises red flags. If a question doesn’t apply to you, it’s essential to write “N/A” instead of leaving it empty. This small detail shows that you are attentive and thorough, qualities that are vital in law enforcement.

Another mistake is not being honest about past experiences or qualifications. Deliberate misstatements or omissions can lead to disqualification. Even if you think a particular piece of information may not look good, it’s better to be truthful. Background checks are thorough, and honesty will always serve you better in the long run.

Many applicants also overlook the importance of legibility. The instructions clearly state that responses should be typed or neatly printed in ink. If your handwriting is difficult to read, it could lead to misunderstandings or even delays in processing your application. Take your time to ensure that your answers are clear and easy to understand.

Additionally, failing to include all relevant agencies where you have applied can be a significant oversight. If you have applied to other law enforcement agencies in the past ten years, it’s crucial to list them all, regardless of the outcome. Omitting this information can appear as though you are hiding something, which can negatively impact your application.

Finally, many applicants forget to initial the pages indicating that they have provided complete and accurate information. This step may seem minor, but it is a vital part of the process. By initialing, you confirm your commitment to honesty and completeness, reinforcing your credibility as a candidate.

Documents used along the form

The Texas Personal History Statement form is a crucial document for individuals applying for licensure as peace officers or jailers in Texas. Alongside this form, several other documents are often required to complete the application process. Each of these documents serves a specific purpose and helps ensure that applicants meet the necessary qualifications and standards for the position.

  • This form allows the agency to conduct a thorough background check on the applicant. It typically includes consent for checking criminal history, employment records, and other relevant personal information.
  • A medical examination report confirms that the applicant is physically fit for the demands of law enforcement work. This document may include results from a physical examination, drug screening, and any other health assessments required by the agency.
  • This form verifies the applicant's educational background. It usually requires details about high school and any post-secondary education, including degrees earned and institutions attended.
  • This document outlines the applicant's work history. It should detail previous employers, job titles, and dates of employment. This information helps the agency assess the applicant's experience and qualifications.
  • Applicants are often required to provide a list of personal references who can speak to their character and qualifications. This form typically includes contact information for each reference and their relationship to the applicant.
  • This form gives consent for the agency to conduct drug testing as part of the hiring process. It is essential for ensuring that applicants are free from illegal substances.
  • This is the primary application form submitted to the agency. It usually includes various sections that require detailed information about the applicant's background, qualifications, and motivations for applying.

Gathering these documents in addition to the Texas Personal History Statement is essential for a successful application process. Each piece of information contributes to a comprehensive evaluation of the applicant, ensuring that only qualified individuals are considered for licensure in law enforcement roles.

Similar forms

The Texas Personal History Statement form is an important document used in the process of becoming a peace officer or jailer in Texas. It shares similarities with several other forms that require personal and background information. Here are eight documents that are similar to the Texas Personal History Statement:

  • Employment Application Form: This document collects personal information, work history, and references, similar to the Texas Personal History Statement, which also requires detailed personal data and previous employment history.
  • Background Check Authorization Form: Like the Texas Personal History Statement, this form asks for consent to conduct a background investigation, ensuring the applicant is truthful about their history.
  • Federal Employment Questionnaire: This form gathers personal and professional history from applicants seeking federal positions, similar to the thorough personal disclosures required in the Texas form.
  • State Licensing Application: Applicants for various state licenses must provide personal details and background information, paralleling the requirements of the Texas Personal History Statement.
  • Military Enlistment Form: This form requires personal history and background checks, akin to the detailed disclosures needed for the Texas Personal History Statement.
  • Volunteer Application Form: Many organizations require volunteers to fill out forms that gather personal information and background history, much like the Texas form does for law enforcement applicants.
  • Professional Certification Application: This document requires detailed personal and professional information to ensure qualifications, similar to the Texas Personal History Statement's focus on an applicant's history.
  • Child Care Background Check Form: This form collects personal information and background checks for individuals working with children, echoing the thoroughness of the Texas Personal History Statement in assessing an applicant's suitability.

Dos and Don'ts

When completing the Texas Personal History Statement form, there are essential dos and don'ts to keep in mind. This guidance will help ensure that your application is filled out correctly and thoroughly.

  • Do read the instructions carefully before starting the form.
  • Do provide complete and accurate information for all sections.
  • Do type or print your responses neatly in ink.
  • Do indicate "N/A" for any questions that do not apply to you.
  • Do use the last page of the form for additional information if needed.
  • Don't omit any relevant information, as it may lead to rejection.
  • Don't provide false or misleading information on the form.
  • Don't forget to initial the page to confirm that your information is accurate.
  • Don't disclose any medical information unless required after a conditional job offer.
  • Don't rush through the form; take your time to ensure all details are correct.

Following these guidelines will enhance the likelihood of your application being processed smoothly. Each detail matters, and your honesty and thoroughness will reflect positively on your candidacy.

Misconceptions

When completing the Texas Personal History Statement form, several misconceptions can lead to confusion or errors. Here are five common misunderstandings:

  • Misconception 1: Only serious criminal convictions matter.
  • Many applicants believe that only felony convictions will impact their application. However, any Class A misdemeanor or certain Class B misdemeanors can also disqualify a candidate. It's essential to disclose all relevant information, as even minor offenses can be scrutinized.

  • Misconception 2: Omitting information is acceptable if it seems minor.
  • Some applicants think that leaving out minor details will not affect their application. In reality, deliberate omissions can lead to automatic rejection. Transparency is crucial, so it’s better to include all relevant information, even if it seems insignificant.

  • Misconception 3: Medical information must be disclosed at this stage.
  • Applicants often worry about revealing medical conditions. However, according to the Americans with Disabilities Act, you are not required to disclose any medical information until after receiving a conditional job offer. This means you can focus on other aspects of the application without concern about health-related questions.

  • Misconception 4: Previous job terminations automatically disqualify you.
  • Many believe that being terminated from a previous job will lead to immediate disqualification. While prior misconduct can be a concern, it is not an automatic disqualifier. Each application is evaluated on a case-by-case basis, and context matters.

  • Misconception 5: The form can be filled out carelessly.
  • Some applicants think that they can fill out the form quickly or without much attention to detail. In fact, accuracy and completeness are vital. The form is a governmental document, and any inaccuracies can have serious consequences, including criminal charges for providing false information.

Key takeaways

When filling out the Texas Personal History Statement form, keep the following key takeaways in mind:

  • Eligibility Requirements: Confirm that you meet all five eligibility requirements for licensure as a peace officer or jailer in Texas before you begin. These include citizenship, educational qualifications, and a clean criminal record.
  • Truthfulness is Crucial: Providing false information or omitting details can lead to rejection of your application. Be honest and thorough in your responses.
  • Document Completeness: Use clear handwriting or type your answers. If a question does not apply to you, indicate this by writing “N/A.”
  • Space for Additional Information: If you need more space for your responses, utilize the last page of the form and reference the question number for clarity.
  • Medical Information: You are not required to disclose any medical or disability-related information until you receive a conditional job offer, in accordance with the Americans with Disabilities Act.
  • Initial for Accuracy: Remember to initial the page to confirm that the information you provided is complete and accurate.