DJJ Form IG/BSU-006 "Annual Affidavit of Compliance With Level 2 Screening Standards" - Florida

What Is DJJ Form IG/BSU-006?

This is a legal form that was released by the Florida Department of Juvenile Justice - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2010;
  • The latest edition provided by the Florida Department of Juvenile Justice;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of DJJ Form IG/BSU-006 by clicking the link below or browse more documents and templates provided by the Florida Department of Juvenile Justice.

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Download DJJ Form IG/BSU-006 "Annual Affidavit of Compliance With Level 2 Screening Standards" - Florida

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IG/BSU-006
Revised 06/10
DEPARTMENT OF JUVENILE JUSTICE
OFFICE OF THE INSPECTOR GENERAL
BACKGROUND SCREENING UNIT
Annual Affidavit of Compliance with Level 2 Screening Standards
STATE OF FLORIDA
COUNTY OF
I,
, with the
,
(Facility Representative)
(Facility/Program)
a contractor or employer with the Department of Juvenile Justice, hereby affirm, under penalty of
perjury, that each employee has complied with the Level 2 background screening requirements as
stated in Chapters 984 and 985 and Section 435.04, Florida Statutes, as well as the Department’s
Background Screening Policy, Procedures, and rules. Employees in positions of special trust or
responsibility have been fingerprinted and t h e fingerprint requests submitted to the Department of
Juvenile Justice, Office of Inspector General, Background Screening Unit. All employees/volunteer
have been screened as required under section 435.04, Florida Statutes, before they were hired or
utilized as a volunteer.
___________________________________________________
SIGNATURE OF AFFIANT
Sworn to and subscribed before me this _______ day of ________________________, 20_________.
__________________________________________________
SIGNATURE OF NOTARY PUBLIC, STATE OF FLORIDA
(Print, Type, or Stamp Commissioned Name of Notary Public)
Affiant personally known to notary
or
Affiant produced Identification
(Check One)
Type of Identification Produced:
Reset/Clear Form
Save As
Print Page
IG/BSU-006
Revised 06/10
DEPARTMENT OF JUVENILE JUSTICE
OFFICE OF THE INSPECTOR GENERAL
BACKGROUND SCREENING UNIT
Annual Affidavit of Compliance with Level 2 Screening Standards
STATE OF FLORIDA
COUNTY OF
I,
, with the
,
(Facility Representative)
(Facility/Program)
a contractor or employer with the Department of Juvenile Justice, hereby affirm, under penalty of
perjury, that each employee has complied with the Level 2 background screening requirements as
stated in Chapters 984 and 985 and Section 435.04, Florida Statutes, as well as the Department’s
Background Screening Policy, Procedures, and rules. Employees in positions of special trust or
responsibility have been fingerprinted and t h e fingerprint requests submitted to the Department of
Juvenile Justice, Office of Inspector General, Background Screening Unit. All employees/volunteer
have been screened as required under section 435.04, Florida Statutes, before they were hired or
utilized as a volunteer.
___________________________________________________
SIGNATURE OF AFFIANT
Sworn to and subscribed before me this _______ day of ________________________, 20_________.
__________________________________________________
SIGNATURE OF NOTARY PUBLIC, STATE OF FLORIDA
(Print, Type, or Stamp Commissioned Name of Notary Public)
Affiant personally known to notary
or
Affiant produced Identification
(Check One)
Type of Identification Produced:
Reset/Clear Form
Save As
Print Page