Form Pi-1 - Application For Licensure - Oregon Department Of Public Safety Standards And Training Page 4
Download a blank fillable Form Pi-1 - Application For Licensure - Oregon Department Of Public Safety Standards And Training in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Pi-1 - Application For Licensure - Oregon Department Of Public Safety Standards And Training with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4
5Moral Fitness
5
Oregon Revised Statutes (ORS) and Oregon Administrative Rules (OAR) require all private investigator
applicants uphold the core values established by the Board of Public Safety Standards and Training and be
6
of good moral fitness as determined by a criminal background check, department investigation or other
reliable sources. Lack of good moral fitness includes, but is not limited to, mandatory or discretionary
disqualifying misconduct as described in OAR 259-061-0300(2).
ORS 703.425(3) requires all applicants must disclose any acts constituting grounds for denial of an
investigator’s license and must notify the department if the applicant is charged with a criminal offense. The
department shall conduct a special review of any applicant making a disclosure.
If you answer yes to any of the below questions, attach an explanation and provide date, location,
and nature of offense.
1) Has a certification or license in any other occupation or professional capacity issued in your name in any
state or by the federal government ever been refused, suspended, revoked or restricted OR have you
ever voluntarily relinquished a certification/license?
YES
NO
Y
E
2) Have you had any action taken against any state issued certificate/license or are you currently being
S
investigated regarding any state issued certificate/license – including DPSST?
YES
NO
N
Y
O
E
3) Have you ever been investigated, required to appear before or been sanctioned by any professional
S
body or federal or state agency for alleged misconduct – including DPSST?
I
f
N
YES
NO
Y
Y
O
E
E
y
4) Have you had an investigator license in another state?
S
S
e
I
YES
NO State(s)____________________________
Year(s)______________________
s
f
N
N
5) Have you ever been convicted of, arrested OR is there any action pending against you for any criminal
,
O
O
y
offense?
a
e
YES
NO
I
I
t
s
f
f
t
,
6) Have you ever committed an act that would be considered a violation of one of the five core values
a
outlined in OAR 259-061-0020 and OAR 259-061-0300? (Dishonest, failure to strive for justice, lack of
y
y
c
a
public trust, lack of respect for the law of this state or nation)
e
e
h
t
s
s
YES
NO
t
,
,
a
a
7) Have you ever been the subject of a lawsuit, arbitration, mediation, or disciplinary action regarding your
n
c
a
a
investigative activities?
h
t
t
e
YES
NO
t
t
x
a
a
a
p
n
Signature of Applicant
c
c
l
h
h
a
6
e
The information contained in this application is true and correct to the best of my knowledge. I understand
n
x
a
that falsification of any documents submitted to the department may be cause for denial or revocation of
a
a
p
7
n
n
licensure under OAR 259-061-0300, and subject to a civil penalty under OAR 259-061-0200. I further
t
l
i
understand that the information provided in this application will be used to conduct a background
a
e
e
o
n
investigation.
x
x
n
a
p
p
t
Signature: ___________________________________________________Date:_______________
l
l
a
i
PI-1 Application for Licensure
Revised: 11/2016
a
a
n
o
n
n
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal