Non Attorney Employment Application Form - State Of New York, Office Of The Attorney General
Download a blank fillable Non Attorney Employment Application Form - State Of New York, Office Of The Attorney General 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 Non Attorney Employment Application Form - State Of New York, Office Of The Attorney General 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
4State of New York
POSITION APPLIED FOR
Office of The Attorney General
Title:
NON ATTORNEY
EMPLOYMENT APPLICATION
Date Available:
/
/
APPLICATION INFORMATION
(Please complete all questions. Type or print in ink.)
Name
______________________________________________________
__________/__________/__________
Social Security Number
Last
First
Middle
Address ______________________________________________________
(______)________________________
Street
Apt. No.
Home Phone
______________________________________________________
(______)________________________
City
State
Zip Code
Cell Phone
(______)________________________
List any other names used if different from above
__________________
Business Phone
_____________________________________________________________
_______________________________
E-mail Address
The Office of the Attorney General provides equal opportunities in employment and prohibits discrimination on the basis of age, sex, race, religion,
creed, color, national origin, alienage or citizenship status, sexual orientation, gender identity, military status, disability, genetic predisposition or carrier
status, marital or partnership status, or domestic violence victim status.
□
□
□
1. U.S. Military Status:
a.
Veteran Status:
Non-Veteran
Veteran
Disabled Veteran
Dates of Service: From
______/______/______
To
______/______/_______
□
□
□
b.
Reserve Status:
None
Inactive
Active
__________________
_________________
_________________
Branch
Type of Discharge
□
□
2. Are you an active Volunteer Fire Fighter?
Yes
No
□
□
3. Do you currently have a valid driver's license which allows you to drive in New York State?
Yes
No
□
□
4. Do you have the legal right to accept employment in the United States?
Yes
No
(Employment is contingent upon your providing proof of the right to accept employment in the United States.)
□
□
5. Are you able to perform the duties of the position for which you have applied without danger to yourself or others?
Yes
No
□
□
6. Have you ever had your driver's license revoked or suspended?
Yes
No
□
□
7. Have you ever been dismissed from a job for any reason except lack of work funds?
Yes
No
□
□
8. Have you ever been convicted of a crime?
Yes
No
□
□
9. Are you aware of any current criminal investigation into your conduct or criminal charges pending against you?
Yes
No
EXPLAIN any "YES" ANSWERS TO Question 6-9 in the REMARKS SECTION on the back page.
□
□
10. Are you currently receiving benefits from any retirement system or pension plan administered by the State of
Yes
No
New York or any of its political subdivisions?
(If "YES," pursuant to NY Retirement and Social Security Law§211(2)(a)(1), the NYS Office of the Attorney General
("OAG") may need to obtain approval to hire you from the NYS Civil Service Commission. Please be advised that
obtaining employment with the OAG may have a significant impact upon you eligibility to continue to receive pension
benefits, and/or the amount of benefits you may be eligible to receive in the future. It is your obligation to discuss with
your pension administrator the financial ramifications to you accepting OAG employment.)
□
□
11. If offered a position with the Office of the Attorney General, will you also intern, volunteer or maintain
Yes
No
employment elsewhere? (If "YES" please identify other concurrent position, including self-employment)
a.
Name of organization _______________________________________________________________________________
Address __________________________________________________________________________________________
b.
Street
City
State/Zip Code
Dates: From ______/______/______ To ______/______/______ Title or Position ______________________________
- 1 -
HRM001 - (rev. 9/12)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business