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The PLCB 1817 form serves as a vital tool in the hiring process for seasonal liquor store clerks within Pennsylvania’s Liquor Control Board. Its comprehensive structure ensures that potential employees provide essential personal information, including contact details, work preferences, and relevant employment history. The form inquires about relationships to current staff, past employment with the Commonwealth, and the presence of any conflicts of interest. Candidates must also disclose any criminal history, which is a crucial aspect given the sensitive nature of alcohol distribution and licensing. The form not only collects personal data but also emphasizes the significance of honesty, outlining the consequences of providing false information. Furthermore, it reinforces the Board's commitment to diversity and equal opportunity employment. Understanding the components of the PLCB 1817 form is essential for anyone looking to navigate the application process successfully, as accuracy and transparency in disclosures play a critical role in determining eligibility for employment.

Plcb 1817 Example

PlCB-1817 9/08

SEASONAL LiquOR STORE cLERk

Bureau Of

Pennsylvania

liquOr COntrOl BOarD

EmPLOymENT APPLicATiON

Human resOurCe management

 

 

 

 

 

 

 

sOCial seCurity nO.

emPlOyee nO. (if previous Commonwealth employee)

WOrk COunty PreferenCe

 

 

 

PERSONAL DATA

last name

first name

m.i.

mailing aDDress (street, P.O. BOX)

City/BOrO/tOWnsHiP

state ZiP CODe

COunty

HOme PHOne nO.

() -

Cell PHOne nO.

() -

email aDDress

vOting aDDress (if Different frOm mailing aDDress) (street, P.O. BOX)

City/BOrO/tOWnsHiP

state ZiP CODe

COunty

yes nO

GENERAL iNFORmATiON

 

 

1.Do you have a relative currently employed with the liquor Control Board? if yes, please state below the name and your relationship to the employee.

2.Have you ever been dismissed from employment for ineficiency, delinquency, or misconduct, or have you ever been permitted to resign to avoid dismissal? explain below.

3.If you resigned from a position, did the resignation occur after receiving information from your employer indicating you may be disciplined? If so, please explain below.

4.Have you previously worked for the Commonwealth?

If yes: Date:___________________________________ Agency_________________________________________________

Date:___________________________________ Agency_________________________________________________

COmments:

cONFLicT OF iNTEREST

a COnfliCt Of interest PrOHiBits emPlOyment WitH tHe Pennsylvania liquOr COntrOl BOarD in aCCOrDanCe WitH tHe liquOr CODe seCtiOn 210. emPlOyment CannOt Be OffereD until tHe COnfliCt is resOlveD. a “yes” ansWer tO any Of tHe fOllOWing questiOns may inDiCate a COnfliCt Of interest. ATTACH ADDITIONAL SHEETS tO eXPlain “yes” ansWers. inCluDe yOur name anD sOCial seCurity numBer On eaCH attaCHeD sHeet.

yes nO

1.Do you or any member of your immediate family* hold any license issued by the Pennsylvania liquor Control Board? if so, what type of license(s)?

2.Do you or any member of your immediate family* hold ofice in any organization which holds a License issued by the Pennsylvania Liquor Control

Board?

3.Do you or any member of your immediate family* have any direct or indirect interest in any business within the Commonwealth dealing in liquor, or alcohol, or malt or brewed beverages, whether as owner, part-owner, partner, member of syndicate, shareholder, independent contractor, manager or agent?

* mEmBERS OF immEDiATE FAmiLy cONSiSTS OF THE FOLLOWiNG: SPOuSE RESiDiNG iN THE PERSON’S HOuSEHOLD AND miNOR DEPENDENT cHiLD.

ARREST/cONvicTiON/ARD iNFORmATiON

fOr tHese questiOns DisregarD: summary traffiC viOlatiOns (nO POints), Offenses COmmitteD BefOre yOur 18tH BirtHDay WHiCH Were aDjuDiCateD in juvenile COurt unDer a yOutH OffenDer laW, anD any CHarges WHiCH Have Been eXPungeD By a COurt Or fOr WHiCH yOu suCCessfully COmPleteD an aCCelerateD reHaBilitative DisPOsitiOn PrOgram.

cRimiNAL OFFENSE: inCluDes felOnies, misDemeanOrs anD summary Offenses.

cONvicTiON: an aDjuDiCatiOn Of guilt anD inCluDes DeterminatiOns BefOre a COurt, a DistriCt justiCe Or magistrate anD Pleas Of nO COntest tHat result in a fine, sentenCe Or PrOBatiOn.

COnviCtiOns WHiCH OCCur after aCCePtanCe Of emPlOyment WitH tHe PlCB may result in yOur Dismissal.

Date Of BirtH

mOntH

Day

year

(This information is required to conduct a criminal history background check)

Please list maiDen name (Or any alias names) WHiCH reCOrDs may Be unDer

yes nO

1. Have you been convicted of a felony in the last (10) years? if yes, please give details below.

Date Of arrest

Crime(s) CHargeD

PlaCe Of arrest

 

 

 

City

state

COunty

 

 

 

COmments - use tHis sPaCe tO eXPlain ‘yes’ ansWer.

yes nO

2. Are there criminal charges of any kind pending against you at this time? if yes, please give details below.

Date Of arrest

Crime(s)

PlaCe Of arrest

 

 

 

City

state

COunty

 

 

 

COmments - use tHis sPaCe tO eXPlain ‘yes’ ansWer.

yes nO

3. Have you ever been convicted, ined, sentenced, placed on probation, pled guilty or no contest, or forfeited bond in the uS or any foreign country as a result of being arrested, charged or cited.

Date Of arrest

Crime(s)

PlaCe Of arrest

 

 

 

City

state

COunty

 

 

 

COmments - use tHis sPaCe tO eXPlain ‘yes’ ansWer.

yes nO

4. Are you currently participating in an Accelerated Rehabilitative Disposition (ARD) Program or other court-ordered program to avoid conviction?

Date Of granting arD

Date Of COmPletiOn

Crime(s)

lOCatiOn Of suPervising COurt

City

state

COunty

terms Of arD

Please reaD Carefully

As a condition to your continued employment, you may be subjected to searches of your person and your possessions when on and/or leaving Commonwealth premises. In the event any property of the PLCB is found in your possession, you will be subject to immediate discharge and prosecution under the law.

The PLCB may conduct investigations regarding medical history, education and conviction records. Therefore, by signing this application you are authorizing the release of the above information to the PLCB and you indicate your awareness that false statements or failure to disclose information may be suficient to disqualify you for employment

or, if employed, may result in your dismissal.

I further understand that employment is conditional until results of information given by me here have been reviewed, considered, and veriied.

signature

Date

THE PA LiquOR cONTROL BOARD iS PROuD TO BE AN EquAL OPPORTuNiTy EmPLOyER SuPPORTiNG WORkFORcE DivERSiTy

Form Characteristics

Fact Title Details
Form Purpose The PLCB-1817 form is an employment application for seasonal liquor store clerks in Pennsylvania.
State Authority This form is governed by the Pennsylvania Liquor Code, specifically referencing Section 210 regarding conflicts of interest and employment prohibitions.
Employment Conditions Employment is conditional based on the review of the information provided in this application, including criminal background checks.
Conflict of Interest Applicants must disclose any potential conflicts of interest, which could disqualify them from employment with the PLCB.
Equal Opportunity The Pennsylvania Liquor Control Board is committed to equal opportunity employment and workforce diversity.

Guidelines on Utilizing Plcb 1817

Completing the PLCB 1817 form is an important step in your application process. Ensuring you provide accurate and thorough information will facilitate your application being considered promptly. The form requires personal data, employment history, and information on any potential conflicts of interest or legal issues. Please take your time to fill it out carefully.

  1. Begin with your personal information. Fill in your last name, first name, and middle initial in the designated fields.
  2. Provide your full mailing address, including street, city or borough, state, and zip code.
  3. Include your home phone number and cell phone number in the respective sections.
  4. Add your email address. Make sure it is one you regularly check.
  5. If your voting address is different from the mailing address, fill that section out as well. Include street, city or borough, state, and zip code.
  6. For the general information section, respond to the questions regarding relatives employed by the Liquor Control Board, any past employment dismissals, and previous work for the Commonwealth.
  7. Next, consider the conflict of interest questions carefully. Indicate whether you or any member of your immediate family holds any licenses related to the Pennsylvania Liquor Control Board.
  8. Fill out the arrest/conviction/ARD information section. If you have a criminal history, include details about any felony convictions in the last ten years.
  9. Sign and date the application. Your signature indicates your understanding and acceptance of the information provided.

After you have completed the form, ensure that all required sections are filled out and that you have included any necessary additional sheets of information if you answered "yes" to any questions that required elaboration. Once everything is finalized, submit your application as instructed.

What You Should Know About This Form

What is the purpose of the Plcb 1817 form?

The Plcb 1817 form is an employment application used by the Pennsylvania Liquor Control Board (PLCB). It collects essential personal and employment history details from individuals interested in working as seasonal liquor store clerks. The form is designed to assess the qualifications and suitability of applicants for the specific roles available within the agency.

What personal information is required on the Plcb 1817 form?

The form asks for various personal details. This includes your full name, mailing address, contact numbers, and email address. Additionally, it requires information about your voting address, if different from your mailing address. You will also need to disclose whether you have any relatives currently working for the PLCB, which helps identify potential conflicts of interest.

What kind of background information must I provide?

Applicants are required to provide background information regarding their employment history and any criminal convictions. You must indicate if you have ever been dismissed from a job, have criminal charges pending, or have been convicted of a felony in the past ten years. Transparency in this area is crucial for ensuring the integrity and safety of the workplace.

Are there restrictions related to conflicts of interest in the Plcb 1817 form?

Yes, the form includes several questions designed to identify potential conflicts of interest. You are asked whether you or any immediate family members hold licenses issued by the PLCB or have a direct interest in a business dealing with liquor. Any affirmative answers will require additional explanations to determine if such interests could impact your employment with the PLCB.

What should I expect after submitting the Plcb 1817 form?

After you submit the form, your application will undergo a review process. The PLCB may conduct background checks, including criminal history and prior employment verification. Employment is conditional, meaning your application will be considered only after these reviews have been completed and confirmed. Be aware that any misinformation or failure to disclose relevant facts may disqualify you from consideration or lead to dismissal if already hired.

Common mistakes

Filling out the PLCB 1817 form is an important step in applying for employment with the Pennsylvania Liquor Control Board. However, there are several common mistakes that can hinder a candidate's chances. Understanding these pitfalls can help ensure a smoother application process.

One frequent error is incomplete personal information. Applicants often forget to provide all requested details, such as their full mailing address, contact numbers, and email address. Missing this crucial information can delay the application process or even result in disqualification. Always double-check that each section is filled out entirely before submitting the form.

Another common mistake involves the conflict of interest questions. Applicants may answer “no” without fully considering their family members' relationships or connections to licensed businesses. It’s essential to be transparent about any potential conflicts. Listing an immediate family member who holds a license may seem insignificant, but it could lead to disqualification if not disclosed.

Misunderstanding the criminal history section is also an issue. Candidates sometimes fail to report all past convictions or believe that expunged records do not need to be mentioned. Even if a record has been sealed or expunged, being upfront about any criminal history is the best course of action. Honesty here is critical; the consequences of failing to disclose can include dismissal.

A significant oversight can occur when applicants fail to provide adequate explanations for “yes” answers in the criminal history segment. When answering questions about felony convictions or pending charges, detailed explanations are necessary. Providing context shows a willingness to be forthcoming and can mitigate concerns.

Some applicants also overlook signature and date requirements. The application will not be valid without a proper signature and date, leading to unnecessary delays. This step is often seen as routine, but it’s vital to remember that it signifies the applicant's agreement with the information provided.

Additionally, submitting the application without attaching required documents is a common mistake. Applicants should always ensure that any requested paperwork, such as additional sheets for explanations, is included with their submission. Incomplete packets may lead to further inquiries or rejection of the application.

Lastly, errors in formatting or handwriting can negatively impact legibility. Filling out the form electronically, if possible, can help avoid this issue. If handwriting is necessary, clarity is essential. An application filled with crossed-out sections or difficult-to-read handwriting may cause confusion and might not be taken seriously.

In conclusion, the PLCB 1817 form requires careful attention to detail. By avoiding these common mistakes, applicants can improve their chances of a successful application and move forward in the hiring process with confidence.

Documents used along the form

The PLCB 1817 form is commonly used during the employment application process for seasonal liquor store clerks in Pennsylvania. Alongside this form, there are several other documents that applicants may need to complete or reference. Below are five forms and documents often utilized in conjunction with the PLCB 1817 form.

  • Background Check Authorization Form: This document grants permission for the Pennsylvania Liquor Control Board (PLCB) to conduct a criminal history background check on the applicant. Providing accurate personal information is crucial for processing this check, which ensures that the applicant meets the required standards for employment.
  • I-9 Form: The I-9 form is used to verify an individual’s identity and employment authorization in the United States. Completed by the employee and employer, it requires submission of specific documents that prove eligibility to work in the country.
  • W-4 Form: This tax form is filled out by the employee to indicate the amount of federal income tax to withhold from their paycheck. Personal information such as filing status and the number of allowances is included to determine the correct withholding amount.
  • Direct Deposit Authorization Form: This form allows employees to authorize their employer to deposit their paychecks directly into their bank accounts. It typically requires the employee's bank account information and is often submitted during the onboarding process.
  • Employee Handbook Acknowledgment Form: This document confirms that the employee has received and understands the company’s policies and procedures as outlined in the employee handbook. Signing this form indicates the employee's commitment to adhere to the established guidelines while employed.

Each of these forms plays a vital role in the hiring process, ensuring that employees fulfill legal requirements and understand their rights and responsibilities within the organization. Proper completion and submission of these documents are essential for a smooth onboarding experience.

Similar forms

  • Employment Application Form: Similar to the PlCB 1817, this form collects personal information and employment history, ensuring employers assess qualifications and background.
  • Background Check Authorization: Like the PlCB 1817, this document requires applicants to consent to a background investigation, which screens for criminal history and other relevant factors.
  • Conflict of Interest Disclosure: This document parallels the PlCB 1817 by asking applicants to reveal potential conflicts that might hinder impartiality in their roles.
  • License Application Form: Similar in purpose, this form requires applicants to disclose any relevant licenses held, ensuring compliance with legal regulations.
  • Self-Disclosure Form: This document mirrors aspects of the PlCB 1817 by soliciting information about previous employment issues, which might affect hiring decisions.
  • Criminal Record Check Form: Like the PlCB 1817, this form is used to gather information on criminal charges or convictions, which is essential for certain positions.

Dos and Don'ts

When filling out the Plcb 1817 form, there are important guidelines to follow. Here are ten things to keep in mind:

  • Do: Read each section carefully before starting to fill out the form.
  • Do: Provide accurate personal information to ensure proper processing of your application.
  • Do: Use clear print or type your responses to maintain readability.
  • Do: Answer all questions truthfully, especially regarding employment history and criminal background.
  • Do: Attach additional sheets if necessary, clearly labeling each one with your name and social security number.
  • Don't: Leave any required fields blank; incomplete forms may delay processing.
  • Don't: Provide misleading information, as this can lead to disqualification or dismissal.
  • Don't: Forget to sign and date the application; an unsigned application may not be accepted.
  • Don't: Assume all inquiries are optional; answer each question thoughtfully.
  • Don't: Submit the form without double-checking for errors or omissions.

Following these guidelines can help ensure a smooth application process.

Misconceptions

Misunderstandings often arise regarding the Plcb 1817 form, which is used for employment applications with the Pennsylvania Liquor Control Board. Here are seven common misconceptions and clarifications to help clear them up:

  • Only candidates with prior liquor experience can apply. Many believe that previous experience in the liquor industry is a requirement. However, the form does not necessitate prior experience to apply for a position.
  • Disclosing criminal history will automatically disqualify an applicant. This is not the case. While applicants must disclose any felonies or pending charges, each application is reviewed on a case-by-case basis, considering various factors.
  • Personal information is not protected. Some applicants worry that their personal data is not secure. The PLCB is bound by regulations to protect sensitive information included in the application.
  • All previous employers must be listed. A common misconception is that every past employer must be included. The form instructs applicants to provide relevant work history, focusing on positions directly related to the Commonwealth.
  • Opportunity for employment is guaranteed upon submission. Many individuals mistakenly think that sending in an application guarantees a job offer. Employment is conditional upon the review of the application and the results of background checks.
  • Any relationship with a PLCB employee disqualifies an applicant. Having a relative employed by the PLCB does raise conflict of interest issues, but it does not automatically disqualify an applicant. The form facilitates disclosure to assess any potential conflicts.
  • Only citizens of Pennsylvania can apply. Some believe that only residents of Pennsylvania are eligible for employment. However, while preference may be given to local candidates, individuals from other states may also apply.

Key takeaways

  • Form Purpose: The PLCB 1817 form is an employment application used specifically for positions with the Pennsylvania Liquor Control Board.
  • Personal Information Required: Applicants must provide basic personal details such as name, mailing address, and contact numbers.
  • Work County Preference: It’s important to indicate your preferred work county, which helps the board in placement.
  • Conflict of Interest Disclosures: Applicants need to answer questions regarding potential conflicts of interest, as certain relationships may disqualify them from employment.
  • Criminal Background Information: The form requires disclosure of any felony convictions within the last ten years and any pending criminal charges.
  • Previous Employment: If you have worked for the Commonwealth previously, you should provide dates and agency details on the form.
  • Resignation Details: If you resigned from any prior position, you must provide information about whether this resignation was tied to potential disciplinary action.
  • Signature and Date: Applicants must sign and date the form, confirming the accuracy of the information provided and acknowledging the employment conditions.
  • Equal Opportunity Employment: The PLCB emphasizes its commitment to diversity and equal opportunity in its hiring practices.