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Government Business And Funding Contracts

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FOR INSTRUCTIONAL USE ONLY

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READ BEFORE COMPLETING YOUR DMA FORM

Forms not conforming to the specifications listed below or not submitted to the appropriate agency or office will

not be processed.

•

To complete this form, you will need a copy of the Terrorist Exclusion List for reference. The Terrorist Exclusion List

can be found on the Ohio Homeland Security Web site at the following address:

•

Be sure you have the correct DMA form. If you are applying for a state issued license, permit, certification or

registration, the “State Issued License” DMA form must be completed (HLS 0036). If you are applying for employment

with a government entity, the “Public Employment” DMA form must be completed (HLS 0037). If you are obtaining a

contract to conduct business with or receive funding from a government entity, the “Government Business and

Funding Contracts” DMA form must be completed (HLS 0038). The Pre-certification form (HLS 0035) should only be

completed if you are specifically instructed to do so by the agency or office requesting the form.

•

Your DMA form is to be submitted to the issuing agency or entity. “Issuing agency or entity” means the government

agency or office that has requested the form from you or the government agency or office to which you are applying

for a license, employment or a business contract. For example, if you are seeking a business contract with the Ohio

Department of Commerce’s Division of Financial Institutions, then the form needs to be submitted to the Department

of Commerce’s Division of Financial Institutions. Do NOT send the form to the Ohio Department of Public Safety

UNLESS you are seeking a license from or employment or business contract with one of its eight divisions listed

below.

•

Department of Public Safety Divisions:

Administration

Ohio Homeland Security*

Ohio Bureau of Motor Vehicles

Ohio Investigative Unit

Ohio Emergency Management Agency

Ohio Criminal Justice Services

Ohio Emergency Medical Services

Ohio State Highway Patrol

•

* DO NOT SEND THE FORM TO OHIO HOMELAND SECURITY UNLESS OTHERWISE DIRECTED. FORMS SENT

TO THE WRONG AGENCY OR ENTITY WILL NOT BE PROCESSED.

FOR INSTRUCTIONAL USE ONLY

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HLS 0038 8/06

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Government Business And Funding Contracts

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