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The Fingerprint Referral Form is a crucial document for individuals seeking employment within the New York City Department of Education (DOE). This form facilitates the background check process, ensuring that candidates are suitable for roles that involve working with children. It consists of several sections that gather vital information from both the referring official and the applicant. In the first section, the referring official must certify the submission, affirming that they have verified the applicant's details. The second section places the onus on the applicant to answer background questions truthfully. These questions probe into areas such as past convictions, employment history, and any pending legal issues that could affect their eligibility. The third section concerns the Office of Personnel Investigation and confirms employment eligibility verification. Each element of the form not only contributes to the integrity of the hiring process but also underscores the importance the DOE places on safeguarding students. Completing the form accurately and honestly is imperative; misrepresentation could lead to severe consequences, including denial of employment. Therefore, it is essential for all applicants to understand the significance of every question and to submit the form in accordance with the clear instructions provided.

Fingerprint Referral Example

The New York City Department of Education

Division of Human Resources & Talent

65 Court Street, Brooklyn, New York 11201

FINGERPRINT REFERRAL FORM

GENERAL INSTRUCTIONS: Please print all information clearly on the form. Section I (Certification Referring Official) must be completed by the appropriate office. Section II (Background Questions) must be completed by the applicant. Section III (Employment Eligibility Verification) will be completed by the Office of Personnel Investigation.

 

 

 

OFFICE USE ONLY

 

 

 

 

 

I-9 CODE

 

 

 

 

ORG.

 

 

 

 

 

 

CODE

 

 

 

 

 

 

Y

REXP. DATE _______/_______/_______

A EXP. DATE _______/_______/_______

PLACE OF BIRTH

HEIGHT/

FEET INCHES

WEIGHT

HAIR COLOR

EYE COLOR

SECTION I: BACKGROUND INVESTIGATION IN THE TITLE OF

Signature of Referring OfficialOffice/DistrictTelephone Number

SECTION II: BACKGROUND QUESTIONS

TODAY’S DATE

SOCIAL SECURITY NUMBER

Month Day Year

LAST NAME

-

FIRST NAME

Month Day Year

-

M.I.

Male Female

OTHER OR MAIDEN NAME

DATE OF BIRTH

CHECK THE BOX BELOW WHICH BEST DESCRIBES YOU:

PLEASE () ONE

1.

2.

AMERICAN INDIAN/ALASKAN NATIVES

3.

ASIAN: INCLUDES ASIAN INDIANS, CHINESE,

4.

JAPANESE, KOREANS, FILIPINOS, INDONESIANS,

 

AND POLYNESIANS

5.

BLACK (Not of Hispanic Origin)

HISPANIC

WHITE (Not of Hispanic Origin)

STREET ADDRESS

 

 

 

 

APT. NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

STATE

 

ZIP CODE

-

-

(AREA)

TELEPHONE NUMBER

FILE NUMBER (IF ANY)

E-MAIL ADDRESS

 

FORM 551 (1096)

Answer “YES” or “NO” to the following questions. If your answer to any of these questions is “YES”, explain, giving details, in the space provided below. You must answer these questions truthfully even though you may have disclosed the same information to the Department of Education or another agency on a previous occasion. Please be advised that if you answer “NO” to question #1 and your fingerprint results disclose a conviction record, your application will be denied. Please sign your name at the end of this section.

YES NO

Have you ever been convicted of or pled "GUILTY" or pled "NO CONTEST" to any offense in this state or

1.elsewhere? [This includes Felonies, Misdemeanors and Violations. For Felonies or Misdemeanors, you must answer "Yes" if you were convicted or pled guilty or no contest even if your records have been sealed.]

2.Are any criminal charges currently pending against you anywhere?

3.Have you ever been placed on a state registry as a sex offender in New York State or elsewhere?

4.Have you ever forfeited bail or bond following your appearance as a defendant in a criminal court action?

5.Has a warrant been issued by a court requiring that you appear in court?

6a.

Has a Family Court ever found that you abused or neglected a child? If so, explain below which court issued

the finding, the nature of the finding, and when it happened.

 

 

6b.

Are you currently in arrears [4 months or more] for child support payments?

 

 

7.

Have you ever been discharged [fired] or required to resign from any position for reasons other than a layoff

due to reduction in the work force?

 

 

8.

Have you ever been denied employment as a result of information obtained following a background check or

 

investigation? If so, explain the reasons for denial of employment below.

9.

Have you ever resigned or left a job rather than face charges or dismissal?

 

 

10a.

Has an employer ever brought or filed charges against you?

 

 

10b.

If yes, were you found guilty of the charges?

11.Have you ever had any professional certificate or license denied, revoked or suspended?

Have you ever applied for a civil service position, such as police officer or worker for a federal, state, city or

12.local agency, and been notified you do not qualify?

Have you ever had a teaching license or certificate denied, revoked or suspended by any Education

13.Department: New York City, New York State or elsewhere?

14.Have you ever received an unsatisfactory rating or unsatisfactory evaluation for your work in a school?

15.Have you ever lost your job as a teacher, or as another pedagogue, before achieving tenure?

16.Did you ever receive a discharge from military service for reasons other than an honorable discharge?

Are you now, or were you ever employed by the NYC Department of Education? If yes, indicate dates

17a. ________________________.

17b.

Were you ever fingerprinted by the NYC Department of Education?

Explanation:

Falsifying an employment application is a punishable offense under the Penal Law of New York State.

Signature of person being fingerprinted

Today’s Date

SECTION III: EMPLOYMENT ELIGIBILITY VERIFICATION

COMPLETE

EXEMPT

Signature of Examiner

Signature of Fingerprint Technician

Form Characteristics

Fact Name Fact Detail
Governing Agency This form is issued by the New York City Department of Education.
Purpose The Fingerprint Referral Form is used for conducting background checks for employment eligibility.
Required Sections Three sections must be completed: Certification Referring Official, Background Questions, and Employment Eligibility Verification.
Falsification Consequence Providing false information on the form is punishable under New York State Penal Law.
Personal Information Applicants must provide personal details such as social security number, date of birth, and employment history.
Legal Basis The applicable law is the New York Education Law governing background investigations for employment.

Guidelines on Utilizing Fingerprint Referral

Once you have gathered all the required information, it’s time to complete the Fingerprint Referral form. This form is essential for the background check process, ensuring that all necessary details are correctly documented. Follow these steps to accurately fill out the form.

  1. Obtain the Form: Make sure you have the official Fingerprint Referral form from the New York City Department of Education.
  2. Section I: Find the area labeled "Certification Referring Official." This section must be filled out by the appropriate office. Ensure this is completed before your submission.
  3. Section II: In the "Background Questions" section, provide your personal information clearly. Fill in your:
    • Today's date
    • Social Security Number
    • Last name, First name, Middle initial
    • Other or Maiden name (if applicable)
    • Date of birth
    • Gender (select Male or Female)
    • Height, weight, hair color, eye color
    • Street address, apartment number, city, state, zip code
    • Telephone number and email address
  4. Demographic Information: Check the appropriate box that best describes your ethnicity. You can only select one option.
  5. Background Questions: Answer all questions truthfully, marking 'Yes' or 'No.' If you answer 'Yes' to any question, provide an explanation in the space provided below the questions. Sign your name at the end of this section.
  6. Section III: The Office of Personnel Investigation will complete the "Employment Eligibility Verification" section. You do not have to fill this part out.
  7. Final Review: Before submitting, review all sections to ensure that everything is filled out accurately and clearly. Check for any missing information to avoid delays.
  8. Submission: Once you are confident that the form is complete, submit it according to the instructions provided by your referring office.

Your next steps involve submitting the completed form and awaiting further instructions from the Department of Education. They will process the information for your background check and keep you informed throughout the procedure.

What You Should Know About This Form

What is the purpose of the Fingerprint Referral form?

This form is utilized for background checks for individuals seeking employment or engagement with the New York City Department of Education. It collects essential information needed to verify the applicant's background, including any potential criminal history.

Who must complete each section of the form?

Section I must be filled out by the referring official from the appropriate office. Section II is designed for the applicant to answer background questions truthfully. Section III is completed by the Office of Personnel Investigation and is not the responsibility of the applicant.

What are the consequences of providing false information on the form?

Providing false information may result in the denial of your application. Falsifying any part of the employment application is a criminal offense under New York State law, which can lead to legal repercussions.

How is personal information such as Social Security Number protected?

The New York City Department of Education is committed to safeguarding personal information. Information collected through the Fingerprint Referral form is used solely for background check purposes and is handled in compliance with applicable data protection laws.

What should an applicant do if they have a past conviction?

If you have a past conviction, you must answer truthfully. The form requires you to disclose any convictions, including sealed records. Failure to do so can jeopardize your application if later discovered.

Can the applicant request a copy of their background check results?

Yes, applicants can usually request a copy of their background check results. Typically, this request must be made following the employer's established procedures. Applicants should inquire about how to obtain these results from the Office of Personnel Investigation.

What types of offenses must be disclosed on the form?

The form requires applicants to disclose any felonies, misdemeanors, and violations. This includes convictions, guilty pleas, and no-contest pleas. Any time you have been involved in a criminal case, you must report it.

Are there any exemptions for individuals with prior employment in the NYC Department of Education?

Individuals previously employed by the NYC Department of Education are still required to complete the Fingerprint Referral form. However, some aspects of the background check process may differ based on previous employment status.

How long does the background check process take?

The duration of the background check can vary based on several factors, such as the applicant's history, the volume of applications being processed, and any complications that may arise. Typically, applicants should allow several weeks for the entire process.

What happens if an applicant is found to have a disqualifying offense?

If an applicant is found to have a disqualifying offense during the background check, the application will be denied. The decision will be communicated to the applicant, along with information on any potential avenues for appeal if applicable.

Common mistakes

Completing the Fingerprint Referral form requires careful attention. One common mistake individuals make is not providing legible information. The instructions specify that all entries must be printed clearly. Illegible handwriting can lead to confusion and potentially delay the processing of applications.

Another frequent error is failing to answer the background questions truthfully. Respondents often skip details or provide vague answers. Any discrepancies found in a background check can lead to application denial, even if the information was disclosed elsewhere. It is critical to answer all questions completely and honestly to avoid complications.

Some individuals neglect to fill out the signature section properly. The form requires the signature of both the person being fingerprinted and the referring official. Omitting either signature can result in the form being returned or rejected entirely.

Many people also make the mistake of not reviewing the entire form before submission. This includes ensuring that all required sections are filled out, double-checking dates, and verifying that the social security number and address are correct. Missing or incorrect details can significantly slow down the process.

Lastly, applicants sometimes fail to check the eligibility requirements for employment indicated on the form. Understanding these requirements can help individuals decide if they should proceed with their application. Failing to meet these criteria will result in unnecessary effort and time spent on a form that cannot be processed successfully.

Documents used along the form

The Fingerprint Referral Form is an essential document for individuals seeking employment with the New York City Department of Education. However, there are several other forms and documents that often accompany this referral. Each of these documents plays a crucial role in ensuring that the background check and verification processes are thorough and compliant with regulatory requirements.

  • I-9 Employment Eligibility Verification Form: This form is used to verify an employee's identity and their eligibility to work in the United States. It requires specific documentation to confirm the individual's identity and employment authorization.
  • Criminal Background Check Consent Form: This form provides consent for the organization to conduct a criminal background check. It often includes personal information and identifies the individual’s agreement to the background screening process.
  • Employment Application: A standard employment application collects personal information, work history, and educational background of the applicant. It helps the employer assess qualifications and fit for the position.
  • Reference Check Form: This document helps in gathering information about an applicant's previous work performance from former employers or professional references. It typically includes instructions and questions aimed at assessing the applicant’s work ethic and character.
  • Disclosure Statement: This statement outlines the applicant’s rights under the Fair Credit Reporting Act (FCRA) concerning their background check. It informs them about how their information will be used and what they can expect from the screening process.
  • Child Abuse History Clearance Form: For positions that involve working with minors, this form verifies any history of child abuse. It is a critical safeguard to ensure the safety of children in educational settings.
  • Employee Orientation Checklist: This checklist includes items for new hires to complete during orientation. It covers essential paperwork and compliance training required to start their position successfully.

These documents, when combined with the Fingerprint Referral Form, create a comprehensive approach to ensuring that all necessary background checks and verifications are completed. Proper handling of these forms is vital for compliance and to maintain the integrity of the hiring process.

Similar forms

  • Employment Application: Similar to the Fingerprint Referral form, an employment application requires applicants to provide personal details, background history, and employment history. Both documents ensure that the applicant undergoes a verification process, though the employment application is typically more focused on job experience and qualifications.

  • I-9 Form: This document is used for employment eligibility verification in the United States. Like the Fingerprint Referral form, it requires applicants to provide identification and personal details. Both documents play crucial roles in ensuring applicants meet necessary legal requirements for employment.

  • Background Check Authorization: This form authorizes an employer to conduct a background investigation, similar to the questions posed in the Fingerprint Referral form. It seeks permission from the applicant to check criminal history, providing insights into the candidate's eligibility and reliability.

  • Certificate of Good Conduct: This document may be requested by some employers to ensure a clean criminal history. Much like the Fingerprint Referral form, it is focused on assessing an individual's background. Both documents relate to the screening process to maintain safety and compliance within the workplace.

Dos and Don'ts

When filling out the Fingerprint Referral form, keep the following guidelines in mind:

  • Do print all information clearly.
  • Do complete all sections accurately, especially the background questions.
  • Do sign the form where indicated.
  • Do provide truthful answers to all questions.
  • Do include your social security number correctly.
  • Don't leave any required fields blank.
  • Don't rush through the form; double-check your entries.
  • Don't falsify any information; it can lead to serious consequences.
  • Don't forget to include additional explanations if needed for your answers.

Misconceptions

1. Misconception: The Fingerprint Referral Form is only for new applicants.

Many believe that only new applicants need to complete this form. In reality, it is also required for current employees seeking to renew their background check or for those who are applying for new positions within the Department of Education.

2. Misconception: All individuals with a criminal record will be automatically disqualified.

While concerns about past convictions are valid, not all criminal records lead to disqualification. Each case is reviewed individually, considering the nature and circumstances of the offense and the time elapsed since it occurred.

3. Misconception: Gaps in employment history will negatively affect my application.

It is a common belief that gaps in employment automatically indicate a problem. However, applicants can explain any gaps in the provided space on the form, allowing for a fuller understanding of their work history.

4. Misconception: Only felony convictions need to be disclosed.

Some applicants think they only need to report felony convictions. In reality, all convictions, including misdemeanors and violations, must be disclosed on the form. Failing to do so can result in serious consequences.

5. Misconception: Answering "No" to background questions is sufficient.

Simply answering "No" may not be enough. If any answers are found to be untruthful later, it can lead to denial of your application. Honesty throughout the process is crucial.

6. Misconception: The form does not require additional documentation.

Some may think the fingerprint referral form is self-sufficient. However, applicants might be required to provide supporting documents for claims made on the form, ensuring a clearer background check process.

7. Misconception: Once fingerprints are submitted, the process is out of my hands.

Though the submission is a critical part of the process, applicants should remain engaged. Following up on the application status can be beneficial. Staying informed is important for peace of mind and future steps.

Key takeaways

Filling out the Fingerprint Referral form correctly is crucial for a smooth application process when dealing with the New York City Department of Education. Below are key takeaways to consider:

  • Clarity is Essential: Print all information clearly to avoid delays in processing your application.
  • Section I must be completed by an authorized official, ensuring the correct person submits the referral.
  • Section II is dedicated to the applicant; provide accurate background information and answer all questions truthfully.
  • The form requires a signature from the referring official and the applicant, which signifies the verification of the information provided.
  • Be mindful of the serious consequences for false disclosures; legal ramifications can arise from providing inaccurate information.
  • Your fingerprint results may influence your application, especially if there is a conviction record, even if previously sealed.
  • Maintain copies of the completed form and any correspondence for your records, as these documents may be useful for future reference.