Form Lea-85a - Continuation Of Certification - Annual In-Service Training Report

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New Mexico Department of Public Safety Training Center
4491 Cerrillos Road, Santa Fe, New Mexico 87507
(505) 827-9251―(877) 237-7532 (NM Only) ―Fax: (505) 827-3449―
Page: 1/2
Law Enforcement Officer
Continuation Of Certification - Annual In-Service Training Report
Year 1(Biennium Period): 2014
Reporting Period:
Year 2(Biennium Period): 2015
Pursuant to DPS LEA Rule 10.29.7.8, the listed courses are submitted in fulfillment of the TWENTY
th
(20) hour annual in-service training requirements. (Due no later than January 15
of each year.)
Name_______________________________________________________________________
Last
First
Middle
Date of Birth ________________SSN______________________Gender_________________
NM State Law Enforcement Certification #:_________________________________________
Home Address:_______________________________City__________________________State______
Zip______________ Contact Number_______ - ________________________________
Email:_____________________________________________
Training Certification
I __________________________________________ hereby certify that the attached (page2)
(Certified Officer/Individual requesting continuation of certification)
information is true and correct and I have completed the listed courses and I have attached as proof of
attendance all training certificate(s) or proof of course attendance ,
OR
a memorandum of completed training, from the Sponsoring Agency/Training Director/Instructor as
proof of completion of training.
Signature______________________________
Date________________________
(Submitting Officer)
Revised 05-28-14
LEA-85A

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