Form CJSTC76A "Exemption-From-Training Proficiency Demonstration" - Florida

What Is Form CJSTC76A?

This is a legal form that was released by the Florida Department of Law Enforcement - 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 August 10, 2017;
  • The latest edition provided by the Florida Department of Law Enforcement;
  • 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 printable version of Form CJSTC76A by clicking the link below or browse more documents and templates provided by the Florida Department of Law Enforcement.

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EXEMPTION-FROM-TRAINING
CJSTC
PROFICIENCY DEMONSTRATION
76A
Florida Department of
Law Enforcement
Incorporated by Reference in 11B-27.002(3)(a)11. and 11B-35.009(6), F.A.C.
1.
Applicant’s name:
2.
Applicant’s Home Address:
City:
State:
Zip Code:
3.
Last Four Digits of Social Security Number:
Applicant’s Home Telephone Number:
4.
Training School’s Name:
5.
Training School’s ORI Number: FL
6.
Training School’s Mailing Address:
7.
Telephone Number:
Ext.
8. Contact Person:
9.
Date Exemption Granted:
10. Law Enforcement Officer Proficiency Checklist:
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The above applicant has complied with the requirements of Section 943.131(2), F.S., and Rule 11B-35.009(6), F.A.C., as verified by
me through examination of supporting documentation on file at the training school.
I acknowledge that the documentation is subject to verification by the Criminal Justice Standards and Training Commission.
Further, I acknowledge that a copy of this form has been provided to the applicant.
13.
14.
Training Center Director or Designee’s Signature
Date Signed
Created 7/1/2002
Original – FDLE
Copy – Training School
Copy – Applicant
Commission-Approved Revisions: 8/10/17
1 of 2
Form Effective Date: 8/2018
EXEMPTION-FROM-TRAINING
CJSTC
PROFICIENCY DEMONSTRATION
76A
Florida Department of
Law Enforcement
Incorporated by Reference in 11B-27.002(3)(a)11. and 11B-35.009(6), F.A.C.
1.
Applicant’s name:
2.
Applicant’s Home Address:
City:
State:
Zip Code:
3.
Last Four Digits of Social Security Number:
Applicant’s Home Telephone Number:
4.
Training School’s Name:
5.
Training School’s ORI Number: FL
6.
Training School’s Mailing Address:
7.
Telephone Number:
Ext.
8. Contact Person:
9.
Date Exemption Granted:
10. Law Enforcement Officer Proficiency Checklist:
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12. Correctional Probation Officer Proficiency Checklist:
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The above applicant has complied with the requirements of Section 943.131(2), F.S., and Rule 11B-35.009(6), F.A.C., as verified by
me through examination of supporting documentation on file at the training school.
I acknowledge that the documentation is subject to verification by the Criminal Justice Standards and Training Commission.
Further, I acknowledge that a copy of this form has been provided to the applicant.
13.
14.
Training Center Director or Designee’s Signature
Date Signed
Created 7/1/2002
Original – FDLE
Copy – Training School
Copy – Applicant
Commission-Approved Revisions: 8/10/17
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Form Effective Date: 8/2018
INSTRUCTIONS FOR COMPLETING FORM CJSTC 76A
Use this form after the Exemption-From-Training form CJSTC-76 has been completed and signed by an agency administrator or selection
center director, and has been submitted and approved by the Criminal Justice Standards and Training Commission.
This form is to be used as a checklist to indicate an out-of-state, federal officer, or inactive Florida officer’s successful demonstration of the
required high-liability proficiency skills. Forms CJSTC-4 CMS, CJSTC-5 CMS, CJSTC-6 CMS, and CJSTC-7 CMS, are to be used to verify
the checklist(s) and shall be maintained in the officer’s file at the training school.
Demonstration of proficiency in the required High-Liability Basic Recruit Training Proficiency Skills and passing the State Officer
Certification Examination shall be completed within one year of notification of approval of the Exemption-From-Training form CJSTC-76, or
apply for any additional exemptions pursuant to the requirements of Section 943.131(2), F.S.
Regardless of the number of exemptions from training an individual receives, the individual shall not take the State Officer Certification
Examination more than three times without enrolling in and completing a Commission-approved Basic Recruit Training Program pursuant
to Section 943.1397(2), F.S.
13. Training Center Director or Designee’s Signature. The
HOW TO COMPLETE EACH ITEM
training center director or designee shall sign his or her
1.
Applicant’s Name. Enter the applicant’s legal name. Enter
name.
the last name and first name. If the applicant has a middle
14. Date Signed. The training center director or designee
initial, enter it.
shall enter the date he or she signed their name.
2.
Applicant’s Home Address. Enter the address of the
TRAINING CENTER REQUIREMENTS
applicant, indicating street name, apartment number, city,
state, and nine-digit zip code.
Following completion of the demonstrations of proficiency,
3.
Applicant’s Social Security Number. Enter the last four
pursuant to Rule 11B-35.009(6), F.A.C., the training center
digits of the applicant’s Social Security number as in this
director or designee shall complete this form and shall,
example: XXX-XX-1234.
within 30 days of the course completion date, electronically
transmit a completed Training Report, form CJSTC-67,
4.
Training School’s Name: Enter the training school’s
through the Commission’s ATMS.
correct name.
Pursuant to Rule 11B-35.009(6), F.A.C., the training center
5.
Training School’s ORI Number.
Enter the training
director or designee shall provide a copy of the completed
school’s ORI number as in this example: FLTRN0000.
form to the officer.
6.
Training School’s Mailing Address. Enter the street
number and name of the street.
AGENCY REQUIREMENTS
7.
Training School’s Telephone Number. Enter the training
Pursuant to Rule 11B-27.002(11), F.A.C., the employing
schools’ telephone number. Enter the training school’s
agency should maintain a copy of this completed form in
telephone number as in this example: 222-222-2222.
the officer’s file at the agency.
8.
Contact Person. Enter the name of the contact person, if
applicable.
9.
Date Exemption Granted. Enter the date on this form that
the exemption was granted.
10. Law Enforcement Officer Proficiency Checklist. Enter
an “X” on the Pass or Fail line. Indicate the date that the
officer demonstrated the particular proficiency. Forms
CJSTC-4 CMS, 5 CMS, 6 CMS, and 7 CMS are to be used
to document the proficiencies for Law Enforcement
Officers.
11. Correctional Officer Proficiency Checklist. Enter an “X”
on the Pass or Fail line. Indicate the date that the officer
demonstrated the particular proficiency. Forms CJSTC-4
CMS, 5 CMS, and 6 CMS are to be used to document the
proficiencies for Correctional Officers.
12. Correctional Probation Officer Proficiency Checklist.
Enter an “X” on the Pass or Fail line. Indicate the date that
the officer demonstrated the particular proficiency. Forms
CJSTC-5 CMS and 6 CMS are to be used to document the
proficiencies for Correctional Probation Officers.
FORM CJSTC-76A
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