[divbox=#f7f7f7][center][img]http://i.imgur.com/rij6lkE.png[/img]
[size=100]LOS SANTOS POLICE DEPARTMENT[/size]
[b][size=130]PRELIMINARY BACKGROUND APPLICATION[/size][/b][/center]

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[img]http://i.imgur.com/dWeOJaG.png[/img] [u][size=160]1. PERSONAL INFORMATION[/size][/u]

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[size=95][u](( IN CHARACTER ))[/u][/size]

[b][u]1.1[/u][/b] Title: Ms
[b][u]1.2[/u][/b] Surname: Cook
[b][u]1.3[/u][/b] Forename: Samntha
[b][u]1.4[/u][/b] Gender: Female
[b][u]1.5[/u][/b] Age: Twenty-two
[b][u]1.6[/u][/b] Nationality: American
[b][u]1.7[/u][/b] Date of Birth: 18th/APR/1994
[b][u]1.8[/u][/b] Race: Caucasian

[b][u]1.9[/u][/b] Phone Number: Eight-seven-three-four.

[b][u]1.10[/u][/b] Place of Birth: Tampa, Florida.
[b][u]1.11[/u][/b] Place of Residence: 968 Deadman's road, Lil' Probe Inn, Bone Country 855, San Andreas
[b][u]1.11.1[/u][/b] Proof of Residence: [url=http://i.imgur.com/awZ4PHc.png]ACCESS[/url]
[b][u]1.12.1[/u][/b] Do you have any medical conditions, mental or physical disabilities? No
[b][u]1.12.2[/u][/b] If yes, please list them here: N/A

[size=95][u](( OUT OF CHARACTER ))[/u][/size]

[b][u]1.13[/u][/b] Forename (OOC): Ortiz
[b][u]1.14[/u][/b] Gender (OOC): Male
[b][u]1.15[/u][/b] In-game level (OOC): 9
[b][u]1.16[/u][/b] Age (OOC): 19
[b][u]1.17[/u][/b] Geographical location (OOC): Ecuador

[b][u]1.18[/u][/b] Time playing LSRP (OOC): 2 years.
[b][u]1.19[/u][/b] Time playing SAMP (OOC): 5 years.

[b][u]1.20[/u][/b] List ALL current and past character names (all previous characters you have used go in the spoilers below) and their levels ([url=http://i.imgur.com/nP15hUw.png?1]example[/url]) (OOC):
[altspoiler=Current Samantha_Cook Level 9]Past Lilith_Black #1[/altspoiler]
[altspoiler=Current Alexander_Bauer Level 1][/altspoiler]
[altspoiler=Current Domo_Knight Level 1][/altspoiler]
[b][u]1.21[/u][/b] List ALL past faction memberships along with your last rank and the reason you left or were removed (OOC): N/A
[b][u]1.21.1[/u][/b] If you were in the LSPD before state the date when you resigned or were terminated (IC/OOC): N/A
[b][u]1.21.2[/u][/b] If you were in the LSPD before then post a link to your Reinstatement request where you were authorized to go through Recruitment (IC/OOC): N/A

[b][u]1.22.1[/u][/b] Are you currently in an official OR unofficial faction with another account, if yes, which faction? (OOC): No
[b][u]1.22.2[/u][/b] If official, post a link to your double factions approval from PD's side (Refer to rule 9) (OOC): N/A

[b][u]1.23.1[/u][/b] LS-RP Forum account (OOC): [url=https://forum.ls-rp.com/memberlist.php?mode=viewprofile&u=307835]xadzer[/url]
[b][u]1.23.2[/u][/b] LS-RP Forum account confirmation (OOC): [url=https://forum.ls-rp.com/viewtopic.php?f=21&t=235770&p=7804185#p7804185]Account confirmation[/url]

[size=95][u](( SCREENSHOTS ))[/u][/size]

[b][u]1.24[/u][/b] Link a unedited screenshot of your admin record for ALL your accounts (OOC):
[spoiler][url=https://i.gyazo.com/e7c8059a76938798c714fe503a225938.png]Image 1[/url]
[url=https://i.gyazo.com/41b9bc0c288249109f1b4d2c4577027b.png]Image 2[/url]
[url=https://i.gyazo.com/5279496a0506b7510159ccb372bc9088.png]Image 3[/url][/spoiler]

[b][u]1.25[/u][/b] Link a unedited screenshot of your in-game statistics (accessed via /stats) for ALL accounts (OOC):
[spoiler][url=http://i.imgur.com/omvPUv4.png]Image 1[/url]
[url=http://i.imgur.com/SQ7EVIv.png]Image 2[/url]
[url=http://i.imgur.com/p5I8xOO.png]Image 3[/url][/spoiler]
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[img]http://i.imgur.com/dWeOJaG.png[/img] [u][size=160]2. LANGUAGE PROFICIENCY[/u][/size]

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[size=95][u](( IN CHARACTER ))[/u][/size]

[b][u]2.1[/u][/b] Can you communicate effectively and efficiently in the English language? - Yes

[b][u]2.2.1[/u][/b] Do you speak any other languages aside English? - Yes
[b][u]2.2.2[/u][/b] If yes, please list them here and your skill level in that language: Spanish fluent

[size=95][u](( OUT OF CHARACTER ))[/u][/size]

[b][u]2.3[/u][/b] Can you communicate effectively and efficiently in the English language? (OOC) - Yes

[b][u]2.4.1[/u][/b] Do you speak any other languages aside English? (OOC) - Yes
[b][u]2.4.2[/u][/b] If yes, please list them here and your skill level in that language (OOC): Spanish fluent

[b][u]2.5[/u][/b] Are you able to function efficiently and effectively in a Teamspeak (VOIP) environment? (OOC) - Yes
[b][u]2.6[/u][/b] Do you possess a working microphone? (OOC) - Yes
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[img]http://i.imgur.com/dWeOJaG.png[/img] [u][size=160]3. LICENSES AND PERMITS[/u][/size]

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[size=95][u](( IN CHARACTER ))[/u][/size]

[b][u]3.1.1[/u][/b] Do you possess a valid San Andreas driving license? - Yes
[b][u]3.1.2[/u][/b] If yes, do you possess any warnings on your license? - No
[b][u]3.1.3[/u][/b] Have or has your drivers license ever been revoked? - No

[b][u]3.2.1[/u][/b] Do you possess a valid aviation license? - No
[b][u]3.2.2[/u][/b] Have or has your aviation license ever been revoked? - N/A

[b][u]3.3.1[/u][/b] Do you possess a valid firearms license? - No
[b][u]3.3.2[/u][/b] If yes, please provide a direct link to your accepted firearms application (If multiple, link each one separately): N/A
[b][u]3.3.3[/u][/b] Have or has your firearms license ever been revoked? - No

[b][u]3.4.1[/u][/b] Do you posses a valid medical license (BLS/ILS)? - No
[b][u]3.4.2[/u][/b] If yes, please provide photo evidence of your medical license: N/A
[b][u]3.4.3[/u][/b] Have or has your medical license ever been revoked? - No
[/list]

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[img]http://i.imgur.com/dWeOJaG.png[/img] [u][size=160]4. EXPERIENCE AND EMPLOYMENT[/u][/size]

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[size=95][u](( IN CHARACTER ))[/u][/size]

Experience and Employment includes establishments or organisations you may have worked for, for voluntary or profitable purposes and should be separated below appropriately, with more fields implemented if required;

Name of Company: N/A
Nature of Work: N/A
Reason for Dismissal: N/A
Employer, if applicable: N/A
Rank, if applicable: N/A
Position, if applicable: N/A

Name of Company: N/A
Nature of Work: N/A
Reason for Dismissal: N/A
Employer, if applicable: N/A
Rank, if applicable: N/A
Position, if applicable: N/A
[/list]

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[img]http://i.imgur.com/dWeOJaG.png[/img] [u][size=160]5. CRIMINAL AND CITATION RECORD[/u][/size]

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[size=95][u](( IN CHARACTER ))[/u][/size]

Criminal and Citation Record includes encounters with the law, from a citation (e.g. vehicle ticket, etc) to a felony (e.g. evading a peace officer, etc), if you were arrested or if you were charged, all separated below appropriately, with more fields implemented if required;

Nature of Sentence: N/A
Date of Sentence: N/A
Time served, if applicable: N/A

Nature of Citation: N/A
Issue Date of Citation: N/A
Amount paid, if available: N/A
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[img]http://i.imgur.com/dWeOJaG.png[/img] [u][size=160]6. REFERENCES AND RECOMMENDATIONS[/u][/size]

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[size=95][u](( IN CHARACTER / OUT OF CHARACTER ))[/u][/size]

References and Recommendations may be given from any current serving employee of the Los Santos Police Department, and should be separated below appropriately, with more fields implemented if required;

[quote]
Employee's full name:  N/A
Employee's current rank:  N/A
Employee's reference: N/A
[/quote]
[quote]
(( Employee's full name: N/A
Employee's current rank: N/A
Employee's reference: N/A ))
[/quote]
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[img]http://i.imgur.com/dWeOJaG.png[/img] [u][size=160]7. APPLICANTS DECLARATION[/u][/size]

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[size=95][u](( IN CHARACTER ))[/u][/size]
[quote][size=85]I certify that the answers contained within this Personal Background Application are true and complete to the best of my knowledge. By agreeing below I hereby authorize investigation of all statements contained within this application for employment as may be necessary in arriving at an employment decision. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee from the recruitment process at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that any false or misleading information given in my application or interview(s) may result in denial and bar from re-application. I understand, also, that I am required to abide by all rules and regulations of the employer.[/size][/quote]
[b][u]7.1[/u][/b] Do you understand and agree to the above declaration: Yes / No

[size=95][u](( OUT OF CHARACTER ))[/u][/size]
[quote][size=85]By submitting this Personal Background Application I acknowledge that I have not been banned from applying for the LSPD and am in good standing with the LSPD. I understand and accept the fact that if proved any OOC lying has taken place in my submitted application that I am responsible and will face admin disciplinary action for OOC lying in a formal application with deceit. I hereby claim that nothing in this application is submitted to be false or of a deceitful nature and everything aforementioned in this application is of 100% accuracy and honesty. I take full responsibility for any recruitment policy violation.

I understand the LSPD and its subordinates (Recruitment officers and Training Officers) have every right to OOC deny my application, or ban me from applying for whatever reason(s), without reason or justification. I also agree that any attempt to transfer over to another law enforcement or government faction has to be agreed upon by the faction leader of the LSPD before it takes place. I understand that this application is of an at will relationship and will abide by all recruitment policies.[/size][/quote]
[b][u]7.2[/u][/b] Do you agree to adhere and understand the above declaration (OOC): Yes
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[img]http://i.imgur.com/dWeOJaG.png[/img] [u][size=160]8. (( ADDITIONAL INFORMATION OR CONCERNS ))[/u][/size]

Requested my other account Lilith_Black to be deactivated since I lost access to the email address registered to that account.

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