Certificate of Suitability Australi an Government Personnel
Information Leaflet
Recognition of a valid Australian Governmen
t Security Clearance1 for any person who
is a Secondee or a Special Member or who has an approved requirement to access
AFP Premises, Classified Information or ICT Systems .
Introduction
A Certificate of Suitability recognises another Agency’s Security Clearance enabling an
employee from that Agency eligible under s.69D (
AFP Act 1979) or s.40E (AFP Act) to access
AFP classified information and/or security controlled areas.
The Employee must provide a copy of their Security Clearance Grant Notification from the host
Agency. The attached forms must be completed before the granting of a Certificate of
Suitability can be considered.
Important Actions
•
Details of Applicant
Please complete all Personal details of the
Applicant.
For the purpose of the Certificate of Suitability Recognition clearance process and where
the form requests details of a partner, spouse, de facto or significant other, this would
include anyone you have been seeing or have been in a relationship with for a period
exceeding 6 months.
•
Agency Security Advisor
The Agency Security Advisor must endorse the application and the integrity of the
applicant.
•
AFP Request and Endorsement
The Functional Area must sponsor the request for the secondee and the application must
be endorsed by the Manager or National Manager of the functional area.
Adjudicative Guidelines
The
AFP employment character guidelines (PDF, 55KB) define the minimum AFP character
standards. Applicants who fail to meet these guidelines, may be deemed unsuitable to proceed
through the Certificate of Suitability process.
Incomplete Packages/Forms
Any missing or incomplete information may result in your documents being returned to you for
further attention. Your AFP sponsor will be notified
should this occur
Contact
If you have any
T qu
H eIsti
S on
Ds a
O bo
C ut
U th
M es
E e
NfoTrm
s
H pleas
AS e
B co
E nEtac
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D uEr A
C FLP Spon
ASS sIor.
FI ED
AND RELEASED IN ACCORDANCE WITH THE
1 Vetting agencies are to recognise the security clearances granted by another vetting agency and or Australian State and Territories undertaken in accordance
FREEDOM OF INFORMATION ACT 1982
with the PSPF, unless:
• the clearance has exceeded its revalidation period (COMMONWEALTH)
• the clearance was granted with an eligibility waiver
• the vetting agency has groun
B dsY th at th
T e c
H lea
E ra nce subject is
AUST not
R suitab
AL leI to a
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Nss AF
F P c
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C lev
Eel
15/10/2018
FOI - CRM 2020/366
Folio - 41
CERTIFICATE OF SUITABILITY – REQUEST FORM
Details of Applicant
Rank/Title
Surname
Given Nam
e/s
Date of Birth
Current Security Clearance (Applicant must attach the Security Clearance Notification letter from the host
Agency)
Agency/company (if contractor)
Clearance Level Held
Date of Grant
Certificate of Suitability (To be completed by the Agency Security Advisor and/or Integrity Department
representative of the home Agency)
I confirm that the applicant has no known integrity or discip
linary issues and is hereby endorsed to have
unescorted access within AFP premises or to AFP systems.
Agency Security Advisor
Contact Number
Signature
Printed Name
Date
Reason for access *****MUST BE COMPLETED *****
Level of clearance required
☐
Baseline
☐
NV1
☐
NV2
Access is required from / /
until / /
AFP Request (to be completed by AFP Team Leader/Coordinator)
I certify that the access requested is necessary for the performance of the applicant’s duties for the purpose
shown above.
Signature
Printed Name
Rank/Position
AFP Number
Date
AFP Endorsement (to be completed by AFP Manager/National Manager)
Signature
Printed Name
Rank/Position
AFP Number
Date
THIS DOCUMENT HAS BEEN DECLASSIFIED
AND RELEASED IN ACCORDANCE WITH THE
FREEDOM OF INFORMATION ACT 1982
(COMMONWEALTH)
BY THE AUSTRALIAN FEDERAL POLICE
FOI - CRM 2020/366
Folio - 42
Form 1. Schedule of Requirements to be attached – Certificate of Suitability
Full Name
Email Address
Contact No/s.
Current (host Agency) Supervisor Details
Name
Contact No/s.
Email Address
Business Area
Forms
Certificate of Suitability Form
Completed
Note: MUST be completed and signed by your AFP Sponsors.
Form 1: Schedule of Requirements to be attached
Completed
Form 2: Security Clearance Questionnaire
Completed
Form 4: Consent to Conduct a National Police Check (Subject)
Completed
Form 4a: Consent to Obtain Personal Information (Partner)
Completed
Form 7: Handling AFP Information
Completed
Form 8: General Consent
Completed
Form 9: Statutory Declaration
Completed
Personal Documents
Note: You MUST provide a copy of your Clearance Notification
Letter and your Drivers Licence or another form of officia
l
photographic ID
Please provide the document title in the space below for substitute documents.
Current Drivers Licence (front & back required)
Must be attached
Clearance Confirmation Letter from home Agency:
Must be attached
THIS DOCUMENT HAS BEEN DECLASSIFIED
Substitute photographic ID for Drivers Licence (if licence not held)
Document Title:
Attached
AND RELEASED IN ACCORDANCE WITH THE
FREEDOM OF INFORMATION ACT 1982
(COMMONWEALTH)
BY THE AUSTRALIAN FEDERAL POLICE
FOI - CRM 2020/366
Folio - 43
Form 2: Security Clearance Questio nnaire
Full Name
Should background checking reveal that you have atte
mpted to deliberately mislead the AFP, it may
cause delays to your security clearance or ultimately
have a bearing on the granting of your security
clearance.
*Please note that answering “yes” to any of these questions does not necessarily preclude you from
obtaining a security clearance. Each issue is assessed on its merits and is based on the circumstances,
your attitude and community standards.*
SECT 137.1 Criminal Code Act 1995
False or misleading information
(1) A person is guilty of an offence if:
(a) The person gives information to another person; and
(b) The person does so knowing that the information:
(i) is false or misleading; or
(ii) Omits any matter or thing without which
the information is misleading; and
(c) Any of the following subparagraphs applies:
(i) The information is given to a Commonwe
alth entity;
(ii) The information is given to a person who is exercising powers or performing functions
under, or in connection with, a law of the Commonwealth;
(iii) The information is given in compliance or purported compliance with a law of the
Commonwealth.
Penalty: Imprisonment for 12 months.
"Giving false or misleading information is a serious offence".
Please answer the fo
T llo
H wIing
S q
Due
Osti
Con
Us b
M y
E tic
N ki
T n g
Hthe re
AS pl
B y
Eth
E at
N a pp
D liEes
C to
L your
ASS pIers
FI on
E al
D c ircumstances.
If you answer
“yes”
AN to
D any
R
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L ue
E stion,
ASE
p
D
le a
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se
N
p
rov
AC
id
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id
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F it w
REith
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I cl
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RMpa
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T aIge
O . NIf y
A ou
C Tw ou
1 ld
9 8pr2e fer to discuss the
matter personally, or have any doubt
( a
Cbout
OM th
Me wo
ONrdin
W g
E o
Af Lan
T y q
H) u estion, please contact Personnel
Security Vetting at xxxxxxxxxxxxxxxx@xxx.xxx.xx.
BY THE AUSTRALIAN FEDERAL POLICE
FOI - CRM 2020/366
Folio - 44
1.
Have you ever been dismissed or asked to resign
from a place of employment? ☐Yes ☐No
If yes, please provide full details
2.
Has a Security Clearance requested for you ever
been:
a) Withdrawn?
☐Yes ☐No
b) Downgraded?
☐Yes ☐No
c) Reviewed?
☐Yes ☐No
d)
Denied?
☐Yes ☐No
If yes, please provide full details
3.
Are you registered with the Australian Electoral C
ommission as a person eligible
to vote?
☐Yes ☐No
If yes, at which address are you registered.
If no, please provide full details as to why not.
THIS DOCUMENT HAS BEEN DECLASSIFIED
AND RELEASED IN ACCORDANCE WITH THE
FREEDOM OF INFORMATION ACT 1982
(COMMONWEALTH)
BY THE AUSTRALIAN FEDERAL POLICE
FOI - CRM 2020/366
Folio - 45
4.
Do you have feelings of loyalty or allegiance to any country other than Australia?
If so, to which country and why.
☐Yes ☐No
5.
Have you, either in Australia or overseas, ever a
pplied for or served with the
Armed Forces, State or Territory Police Services or Correctional Services
(including unsuccessful applications)? If yes, please provide the date of
☐
Yes ☐No
application and/or dates of service.
If you were unsuccessful please include any reasons you were given as to why.
6.
Have you, in Australia or overseas, ever been the
subject of or involved in any
form of:
a) Military investigation?
☐Yes ☐No
b) Police investigation?
☐Yes ☐No
c) Internal investigation?
☐Yes ☐No
d) Workplace enquiry?
☐Yes ☐No
e)
Internal disciplinary action, including counselling whether formal or
informal?
☐Yes ☐No
If yes, please provide as much detail as possible
.
Note that any past involvement, including any adverse findings made against
you, with AFP PRS must be disclosed. If you are
an AFP appointee, you are
authorised to disclose this information under s 60A of the AFP Act and related
regulations. THIS DOCUMENT HAS BEEN DECLASSIFIED
AND RELEASED IN ACCORDANCE WITH THE
FREEDOM OF INFORMATION ACT 1982
(COMMONWEALTH)
BY THE AUSTRALIAN FEDERAL POLICE
FOI - CRM 2020/366
Folio - 46
7.
Have you for any reason (other than in an official capacity)
in any country, ever
been:
a)
☐Yes ☐No
In contact with police or law enforcement
agencies?
☐Yes ☐No
b)
Charged and/or convicted of any offence (including traffic offences)?
☐
Yes ☐No
c) Directed to perform Community Service by a court of law?
☐Yes ☐No
d) Imprisoned or served periodic detention (civilian or military)?
If yes, please provide as much detail as possible.
8.
Do you have (for any reason other than in an official capacity) ongoing or
previously had, contact with anyone who, in any country:
a)
☐Yes ☐No
Is or has been imprisoned or serving periodical detention?
b)
☐Yes ☐No
Is performing or has been directed to perform Community Service by a
court of law?
Note: this includes relatives and family mem
bers
If yes, please provide full details.
THIS DOCUMENT HAS BEEN DECLASSIFIED
AND RELEASED IN ACCORDANCE WITH THE
FREEDOM OF INFORMATION ACT 1982
(COMMONWEALTH)
BY THE AUSTRALIAN FEDERAL POLICE
FOI - CRM 2020/366
Folio - 47
9.
Have you ever (for any reason other than in an official capacity) been involved in
any civil or criminal court matters, in any country, in any capacity?
☐Yes ☐No
If yes, please provide full details.
10. Have you ever engaged in any unlawful activities , in any country, whether
detected by the Police or Law Enforcement Agen
cies or not?
☐Yes ☐No
If yes, please provide full details.
11. Have you ever had contact with anyone, (for any reason other than in an official
capacity), in any country who is or has been involved in criminal or unlawful
activity?
☐Yes ☐No
Note: this includes relatives and family mem
bers
If yes, please provide full details.
THIS DOCUMENT HAS BEEN DECLASSIFIED
AND RELEASED IN ACCORDANCE WITH THE
FREEDOM OF INFORMATION ACT 1982
(COMMONWEALTH)
BY THE AUSTRALIAN FEDERAL POLICE
FOI - CRM 2020/366
Folio - 48
12.
Have you been a member of any type of gang in any country?
☐Yes ☐No
If yes, please provide full details.
13.
Have you had association (other than in an offici
al capacity), in any country, with
anyone who is, or has been a member of any typ
e of gang?
☐Yes ☐No
Note: this includes relatives and family memb
ers
If yes, please provide full details.
14.
Have you ever, on any occasion, in any country?
a) Used illegal/illicit drugs or substances?
b)
☐Yes ☐No
Possessed, sold or manufactured illegal/illicit drugs or substances?
c) Had association with anyone; including relatives and family members
☐Yes ☐No
(other than in an official capacity) involved in illegal/illicit drugs or
☐
Yes ☐No
substances, in any way?
Note: This includes drugs or substances tha
t would be considered illegal
in Australia, regardless of their standing overseas.
If yes, please provide full details.
THIS DOCUMENT HAS BEEN DECLASSIFIED
AND RELEASED IN ACCORDANCE WITH THE
FREEDOM OF INFORMATION ACT 1982
(COMMONWEALTH)
BY THE AUSTRALIAN FEDERAL POLICE
FOI - CRM 2020/366
Folio - 49
15.
Have you ever been, or are you currently being treated for a mental health
disorder or a serious medical condition?
☐Yes ☐No
If yes, please provide full details
16.
Have you ever used prescription or over the counter medications other than as
prescribed or for their intended purpose?
☐Yes ☐No
If yes, please provide full details
17.
Is there any further information about you or your background of relevance that
has not been asked in a previous question?
☐Yes ☐No
If yes, please provide full details
THIS DOCUMENT HAS BEEN DECLASSIFIED
AND RELEASED IN ACCORDANCE WITH THE
FREEDOM OF INFORMATION ACT 1982
(COMMONWEALTH)
BY THE AUSTRALIAN FEDERAL POLICE
FOI - CRM 2020/366
Folio - 50
I certify that the information supplied on this Security
Clearance Questionnaire is complete and correct
to the best of my knowledge.
Applicant
Printed Name: ………………………………………….
Signature: ……………………………………
Date: …………………………
I understand that giving false or misleading inform ation during any part of this security clearance
process is a serious offence under s137.1 & s137.1A of
the
Criminal Code Act 1995.
THIS DOCUMENT HAS BEEN DECLASSIFIED
AND RELEASED IN ACCORDANCE WITH THE
FREEDOM OF INFORMATION ACT 1982
(COMMONWEALTH)
BY THE AUSTRALIAN FEDERAL POLICE
FOI - CRM 2020/366
Folio - 51
Form 4: Consent to Conduct a National Po
lice Check (NPC)
National Police Check Information Leaflet
al ows the AFP as a law enforcement agency to take into
account information in relation to spent convictions for the
purpose of making decisions in relation to assessing AFP
General Information
appointees and contractors
.
This consent form is used by the Australian Federal Police
(AFP) as part of:
Database registration
a. the assessment process to determine whether a
person is suitable for employment or engagement
Your finger and palm prints wil be registered on and
by the AFP as a contractor, special member or
searched against the Australian Criminal Intel igence
secondee;
Commission National Automated Fingerprint Identification
b.
System (NAFIS) database which contains Police and
the security clearance process to determine
whether a person is suitable to occupy a position
Immigration records of people and fingerprints.
determined by the Commissioner of Police to
require a security clearance
Examples of the records held on NAFIS include, but are
c.
not limited to:
verifying the identity of AFP appointees
•
fingerprints relating to unsolved investigations;
•
persons who have been fingerprinted in relation
Unless statutory obligations require otherwise, the
to criminal offences;
information provided on this form wil not be used without
•
NPC for employment/probity purposes and
your prior consent for any purpose other than set out in
security vetting clearances;
this information leaflet and the NPC consent form. You
•
other State/Territory Police Service
may be required to complete another NPC consent form in
recruitment/engagement;
the future if your position or role changes.
•
overseas visa applications; and
•
other civil process matters.
The reasons for conducting the NPC and taking your finger
Once registered on the NAFIS database, your finger and
and palm prints include:
palm prints will then be visible to any search (existing
•
verification of identity for security, character and
person or latent print) conducted by any relevant
disaster victim identification purposes;
organisation in Australia.
•
identification of the existence of police records
relating to you, including records under different
These organisations currently include, but are not limited
names;
to: the AFP, State and Territory Police Services, and the
•
investigation related purposes, including unsolved
Department of Immigration and Citizenship. These
crime scenes and elimination of prints from crime
searches may involve searches of overseas records
scenes;
against the Australian records held on the NAFIS
database.
National Police Check
Checking for the existence of police records is an integral
Storage and Retention
part of the suitability assessment; verification of identity
The information you provide to the AFP wil be:
and the security vetting process.
•
used and handled in accordance with the
Privacy
The information in the NPC consent form and the finger
Act 1988 (Cth); and
and palm prints you provide wil be forwarded to AFP
•
retained and disposed of in accordance with the
Criminal Records who will provide the information to the
Archives Act 1983 (Cth) (the Archives Act).
Australian Criminal Intel igence Commission and
Australian State and Territory Police Services for the
Your NPC documents and finger and palm prints wil be
purpose of conducting checks and extracting details of
retained and stored as part of normal agency record
any convictions, findings of guilt or pending court
.
keeping for your AFP Personal Security File. The AFP wil
Any matters that are identified may be used by the AFP to
not permanently retain the NPC and fingerprints. The
assess:
fingerprints wil be removed from NAFIS and disposed of
•
your suitability for employment or providing
according to retention periods under the Archives Act and
services to the AFP;
disposal obligations for AFP Personal Security Files.
•
your suitability to hold an AFP security clearance;
•
involvement in an unsolved investigation; or
Provision of False or Misleading Information
•
the existence of any undisclosed convictions,
findings of guilt or pending matters.
You are asked to certify that the personal information you
have provided on the form is correct. If it is subsequently
THIS DOCUMENT HAS d
B isco
EEver
N e d Dtha
E t
C yo
L u have
ASS Ipro
FIvid
E ed
D false or misleading
Disclosing convictions
information, for example as a result of a National Police
AND RELEASED IN ACCORDANCE WITH THE
The NPC consent form requires you to disclose whether
Check, you may be assessed as unsuitable to occupy the
you are the subject of any criminal charges(s) pending, or
position for which you are being assessed.
FREEDOM OF INFORMATION ACT 1982
whether you have been the subject of any conviction(s) or
You should note that the existence of a criminal record
finding(s) of guilt before a court, including any conviction
does not mean that you wil be automatical y assessed as
(COMMONWEALTH)
that has become spent.
being unsuitable for employment or unsuitable to be
granted a security clearance. Each case is assessed on its
BY THE AUSTRALIAN FEDERAL POLICE
merits. Therefore it is in your best interests to provide
As a law enforcement agency the AFP has an exclusion
frank and complete details when completing this form.
from the Commonwealth Spent Convictions Scheme as
contained in the
Crimes Act 1914 (Cth). This exclusion
FOI - CRM 2020/366
Folio - 52
Form 4: Consent to Conduct a National Po
lice Check (NPC)
Personal Particulars
(please use BLOCK letters)
Surname
Given Name (s)
Maiden Name
Name by Previous Marriage
Any Other Name Change
Gender
☐ M (Male)
☐
F (Female)
☐
X (Indeterminate/Intersex/Unspecified)
Marital Status
Single
Married
Divorced
Separated
De-facto
Widow (er)
Date of Birth
City/Town (of birth)
State (of birth)
Country (of birth)
Drivers Licence No
Date Of Expiry
State of Licence
Contact Telephone Nos. (H)
(W)
(M)
Permanent Residential Address (Australia)
Period of Residence
Current
Postcode:
/ / to / /
Previous
Postcode:
/ / to / /
Criminal Charge(s), Infringements, Convictions or Pecunia
ry Penalties
1
Are you the subject of any criminal / traffic charge(s) stil pending?
Yes
No
If YES, please provide details
2
Do you have any conviction(s) or finding(s) of guilt?
Yes
No
If YES, please provide details
OFFICE US
E ONLY
Return Completed Form to:
Vetting Officer
Team No.
Australian Federal Police
Initial
For POLICE Use Only
Personnel Security Vetting THIS DOCUMENT HAS BEEN
DECL
Result
ASSIFIED
Security
GPO Box 401
AND RELEASED IN ACCORDANCE WITH THE
Canberra City 2601
FREEDOM OF INFORMATION ACT 1982
(COMMONWEALTH)
BY THE AUSTRALIAN FEDERAL POLICE
FOI - CRM 2020/366
Folio - 53
Form 4: Consent to Conduct a National Police Check (NPC)
I,
Hereby:
(FULL NAME IN BLOCK LETTERS IN INK)
1. acknowledge that I have read the information leaflet provided with this form
This check is for the following purpose:
Employment:
Sworn/Unsworn
Prospective employee/contractor
Existing employee/contractor
Security Clearance:
Access to Secret/Top Secret
Other
2. certify that the personal information that I have provided on this form, including fingerprints and
palm prints, relates to me and is correct;
3. acknowledge the details contained on this form
, including fingerprints and palm prints, will be
forwarded to the AFP, the Australian Criminal Intelligence Commission and/or State/Territory police
services;
4.
consent to the AFP and any other State/Territory police services extracting details of any convictions,
findings of guilt or pending court proceedings relating to me, including in relation to any traffic
offence, and providing that information to the AFP ;
5. acknowledge the information provided on this form
will not be used without my prior consent for any
other purpose than set out in this consent form and the attached National Police Check Information
Leaflet, unless otherwise authorised by law;
6. understand that it is an offence to provide false o
r misleading information in this application, or omit
to provide information that may result in this application being false or misleading; and
7. acknowledge that any information provided on this form or disclosed as a result of this check may be
taken into account in assessing my suitability for
employment or providing services to the AFP as an
AFP appointee or contractor.
Signed:
Date:
NOTE
“Employment” includes engagement as a contractor.
Please ensure that you sign and date the form and complet
e all sections
THIS DOCUMENT HAS BEEN DECLASSIFIED
AND RELEASED IN ACCORDANCE WITH THE
FREEDOM OF INFORMATION ACT 1982
(COMMONWEALTH)
BY THE AUSTRALIAN FEDERAL POLICE
FOI - CRM 2020/366
Folio - 54
Form 4a: Consent to Obtain Personal Info
rmation – Partner
Police Record Check Information Leaflet
General Information
Spen
t Convictions Scheme
This form is used by the Australian Federal Police as Commonwealth legislation relating to collection, use and
part of the security clearance process for your partner disclosure of old convictions information (commonly known as
in accordance with Australian Government Policy.
the Spent Convictions Scheme) restricts the ability of
Unless statutory obligations require otherwise, the Commonwealth Agencies to access this information.
information provided on this form wil not be used The a
im of the scheme is to prevent discrimination on the
without your prior consent for any purpose other than in basis of certain old conviction types once a waiting period has
relation to the assessment of your partner’s suitability passe
d, provided that the individual has not re-offended. The
for employment and/or the granting of their security scheme also covers situations where an individual’s conviction
clearance. You may be required to complete another has been set aside or pardoned.
consent form in the future in relation to their An individual whose conviction is Spent by Part VIIC of the
employment in other positions.
Crimes Act 1914 does not have to disclose that conviction to
Police Records Check
any p
erson, including the Commonwealth authority, exclusion
Police records are an integral part of the suitability applies. Commonwealth authorities are prohibited from taking
assessment process. On this form you are asked to into account or from disclosing, without the consent of the
disclose whether you are the subject of any criminal individual, such convictions.
charges(s) stil pending, or whether you have been the A spent conviction is a conviction for either a Commonwealth,
subject of a conviction(s) or finding(s) of guilt before a Territory, State or foreign offence which satisfies the fol owing
court. You are not required to reveal any convictions, conditions:
which may be protected by Part VIIC of the
Crimes Act
•
it is 10 years since the date of the conviction (or 5
1914, relating to pardoned, quashed or spent
years for child offenders);
convictions, except where exclusion applies (see
•
the individual was not sentenced to imprisonment for
explanation note under heading Spent Convictions
more than 30 months;
Scheme).
•
the individual has not re-offended during the 10 years
You are asked to consent to:
(5 years for child offenders) waiting period, and
a.
•
the AFP conducting Criminal Records checks;
A statutory or regulatory exclusion does not apply. (A
and
ful list of exclusions is available from the Privacy
b.
Commissioner).
the AFP accessing the records of any State or
Territory in which you have visited or resided, An individual who believes that standards dealing with
as nominated in the Personal Particulars section disclosure and use of old conviction information have been
of the form, to obtain any criminal history breached may apply to the Office of the Australian Information
information
in
order
to
make
the Commissioner for an investigation of the matter. The address
employment/security clearance decision in is GPO Box 5218, Sydney NSW 2001, or they can be contacted
relation to your partner.
by email at xxxxxxxxx@xxxx.xxx.xx.
General Security Checks
Prov
ision of False or Misleading Information
In addition to the police check above, various You are asked to certify that the personal information you
enquiries/checks may be undertaken about you have provided on the form is correct. If it is subsequently
(including checks with vetting agencies, other Law discovered for example as a result of police records, that you
Enforcement
Agencies
or
State/Territory
or have provided false or misleading information, your partner
Commonwealth Entities) to determine whether your may be assessed as unsuitable to occupy the position for
partner can be granted a security clearance. These which they are being assessed.
checks may include corroboration of any previous You sh
ould note that the existence of a criminal record does
Commonwealth
employment
you
have
had; not mean that your partner will be automatical y assessed as
corroboration of personal history for a minimum of 10 being
unsuitable for employment or the granting of security
years; corroboration of overseas travel; checks for clearance. Each case wil be assessed on its merit therefore it
bankruptcy; and criminal records checks.
is in your best interests to provide accurate details on the
form.
THIS DOCUMENT HAS BEEN DECLASSIFIED
AND RELEASED IN ACCORDANCE WITH THE
FREEDOM OF INFORMATION ACT 1982
(COMMONWEALTH)
BY THE AUSTRALIAN FEDERAL POLICE
FOI - CRM 2020/366
Folio - 55
Form 4a: Consent to Obtain Personal Information - Partner
Personal Particulars
Nil exclusion
Surname
Given Name(s)
Maiden Name
Name by Previous Marriage
Any Other Name Change
Gender
☐ M (Male)
☐
F (Female)
☐
X (Indeterminate/Intersex/Unspecified)
Relationship to Applicant
Date of Birth
City/Town (of birth)
State (of birth)
Country (of birth)
Drivers Licence No
Date Of Expiry
State of Licence
Contact Telephone Nos. (H)
(W)
(M)
Permanent Residential Address (Australia)
Period of Residence
Current
Postcode:
/ / to / /
Previous
Postcode:
/ / to / /
Criminal Charge(s), Infringements, Convictions or Pecuniary Penalties
1
Are you the subject of any criminal / traffic charge(s) stil pending?
Yes
No
If YES, please provide details
2
Do you have any conviction(s) or finding(s) of guilt?
Yes
No
If YES, please provide details
OFFICE US
E ONLY
Return Completed Form to:
Vetting Officer
Team No.
Australian Federal Police
Initial
For POLICE Use Only
Personnel Security Vetting THIS DOCUMENT HAS BEEN
DECL
Result
ASSIFIED
Security
GPO Box 401
AND RELEASED IN ACCORDANCE WITH THE
Canberra City 2601
FREEDOM OF INFORMATION ACT 1982
(COMMONWEALTH)
BY THE AUSTRALIAN FEDERAL POLICE
FOI - CRM 2020/366
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Form 4a: Consent to Obtain Personal Info rmation - Partner
I,
Hereby:
(FULL NAME IN BLOCK LETTERS IN INK)
8. acknowledge that I have read the information leaflet provided with this form
This check is in relation to my partner and is for the fol owing purpose:
Employment:
Sworn/Unsworn
Prospective employee/contractor
Existing employee/contractor
Security Clearance:
Access to Secret/Top Secret
Other
Site Access:
Access to AFP premises
9. certify that the personal information provided on t
his form relates to me and is correct;
10. acknowledge that the details contained on this form, may be forwarded to the AFP, the Australian
Criminal Intelligence Commission, other Commonwealth entities and/or State/Territory Police
Services;
11. consent to the AFP and any other State/Territory Police Services extracting details of any
convictions, findings of guilt or pending court proceedings relating to me, including in relation to any
traffic offence, and providing that information to the
AFP ;
12. acknowledge that the information provided on this form will not be used without my prior consent for
any purpose other than set out in this consent form and the attached National Police Check
Information Leaflet, unless otherwise authorised b
y law;
13. understand that it is an offence to provide false or misleading information in this application, or omit
to provide information that may result in this application being false or misleading; and
14. acknowledge that any information provided on thi
s form or disclosed as a result of this check may be
taken into account in assessing my partner’s suitability for employment or providing services to the
AFP as an AFP appointee or contractor.
Signed:
Date:
NOTE
“Employment” includes engagement as a contractor, secondee or special member.
Please ensure that you sign and date the form and complete all sections
THIS DOCUMENT HAS BEEN DECLASSIFIED
AND RELEASED IN ACCORDANCE WITH THE
FREEDOM OF INFORMATION ACT 1982
(COMMONWEALTH)
BY THE AUSTRALIAN FEDERAL POLICE
FOI - CRM 2020/366
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Form 7: Handling AFP Information – Some Applicable Legislative Provisions
1. General
There are many Commonwealth laws that apply to Commonw
ealth employees, contractors and other people working for the
AFP. Some of these provisions are summarised below, however this list is not intended to be exhaustive. They represent
examples of some provisions that might apply in respect of i
nformation about what you may encounter while working for the
AFP.
In most instances, these laws wil continue to apply even after you have ceased working with the AFP, this legislation is
available at: www.comlaw.gov.au
If you have any questions regarding this document please contact AFP Personnel Security Vetting.
2. Australian Federal Police Act 1979
Section 60A provides that:
1) This section applies to a person who is, or was at any time:
a) the Commissioner; or
b) a Deputy Commissioner; or
c) an AFP employee; or
d) a special member; or
da) a special protective service officer;
or
e) a person engaged under section 35; or
f) a person performing functions under an agreement under section 69D.
2) A person to whom this section applies must not, directly
or indirectly:
a) make a record of any prescribed information; and
b) divulge or communicate any prescribed information to any other person;
except for the purposes of the AFP Act or the regulations or the Witness Protection Act 1994 or regulations under that Act, or
for the carrying out, performance or exercise of any of the
person's duties, functions or powers under this Act or the
regulations or the Witness Protection Act 1994 or regulations under that Act.
3.
Penalty: Imprisonment for 2 years
In this section, ‘prescribed information’ means information obtained by a person to whom this section applies in the course of
carrying out, performing or exercising any of the person's duties, functions or powers under this Act or the regulations or the
Witness Protection Act 1994 or regulations under that Act, or otherwise in the course of the person's service, employment or
engagement under this Act or the regulations or the Witness Protection Act 1994 or regulations under that Act.
4. Other secrecy provisions
There are other secrecy provisions which may apply. These include, for example, Section 70 of the Crimes Act 1914 (Cth)
which prohibits a Commonwealth Officer communicating information obtained by virtue of being a Commonwealth Officer
which it is his/her duty not to disclose.
Additional y there are many other secrecy provisions that might apply to certain types of other information that persons
working with the AFP may encounter. They include, for example, information relevant to the investigation of complaints
against AFP personnel, telecommunications information, financial information, and some information obtained from other
countries.
5. Computer Offences
The Criminal Code Act 1995 (Cth) includes many offences relating to unauthorised access to or modification or impairment of
computer data.
6. Privacy Act
AFP is an APP entity and an agency for the purposes of the
Privacy Act 1988 (Cth). Accordingly, it is bound by the 11
Australian Privacy Principles at section 14 of the Privacy Act in relation to the col ection, storage, use and disclosure of
personal informatio
T n.
HIS DOCUMENT HAS BEEN DECLASSIFIED
7. Other
AND RELEASED IN ACCORDANCE WITH THE
There are a wide range of other offences that may arise from improper handling of AFP information. For example, dishonestly
using information to obta
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2 e under the Criminal Code
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(COMMONWEALTH)
BY THE AUSTRALIAN FEDERAL POLICE
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Form 7: Handling AFP Information – Some Applicable Legislative Provisions
I,
(Name in BLOCK letters)
Of
In the State of
(Address)
Understand that I am/will be engaged as: (Please tick a
ppropriate box)
a Deputy Commissioner; or
an AFP employee; or
a special member; or
a person engaged under section 35; (consultant / contractor); or
a person performing functions under an agreement under section 69D (secondment).
Understand that I have been identified as requiring access to AFP resources only e.g. PROMIS
Government personnel identified as requiring access to AFP resources only (PROMIS).
Acknowledge and
Agree to the following:
In the course of my employment with, or whilst providing services or assistance to, the Australian Federal Police
(‘AFP’), I may become aware of information (including personal information) that may be:
•
confidential;
•
subject to the
Privacy Act 1988 (Cth); or
•
subject to Commonwealth secrecy laws.
The
Australian Federal Police Act 1979 (Cth) secrecy provision provides that any information obtained in the course of
carrying out, performing or exercising any AFP duties, fu
nctions or powers is protected (referred to as ‘AFP
information’).
I understand that improper access, use or disclosure of AFP information may severely damage the reputation of the
AFP or the AFP’s ability to perform its statutory functions and m
ay constitute a criminal offence.
I must not use, disclose, divulge, communicate or record AFP information except in the course of
performing my duties or providing services or assistance
to the AFP.
I am considered to be a Commonwealth Officer as defined by the
Crimes Act 1914 (Cth) and/or a Commonwealth
Public Official as defined in the
Criminal Code 1995 (Cth).
I have received a copy of the document titled “
Handling AFP Information – Some Applicable Legislative Provisions” (see
attached), that sets out some of the applicable provisions relating to the access, use and disclosure of AFP information.
I understand that these provisions may apply irrespective of whether a document is marked with a security
classification.
I am aware that giving false or misleading information to the Commonwealth is a serious offence under Division 137 of
the
Criminal Code Act 1995 (Cth), punishable by imprisonment for 12 months.
I understand that these obligations are ongoing and their applicability does not depend on whether I continue to work
with the AFP.
THIS DOCUMENT HAS BEEN DECLASSIFIED
AND RELEASED IN ACCORDANCE WITH THE
Printed Name: ....................................... Signature: ………………….
Date:
FREEDOM OF INFORMATION ACT 1982
(COMMONWEALTH)
BY THE AUSTRALIAN FEDERAL POLICE
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Form 8: General Consent
I
(Full Name)
of
(Address)
have read the Australian Federal Police (AFP security clearance information leaflet, and Notes below which explain
the need for me to undergo the security clearance proces
s in accordance with Australian Government Policy. I
acknowledge that this process requires the AFP to make various enquires/checks about me (including checks with
Authorised Vetting Agencies, other Law Enforcement Agencies, State/Territory or Commonwealth Entities or
Personal History Authentication Authorities). I consent to:
•
the AFP having access to and sharing relevant information and documents about me which will assist in the
making of a decision about my suitability for employment and a security clearance;
•
this information being further disseminated within the AFP and to Authorised Vetting Agencies, other Law
Enforcement Agencies or State/Territory or Commonwealth Entities for the purpose of ongoing employment
suitability and/or integrity assessments and any review of a security clearance;
•
the communication of such information to such AFP
appointees, contractors or consultants (and/or their
equivalent in the relevant external agencies) whose duties are conducive to those processes;
•
this information being disclosed to future prospective employers for the purpose of determining my
suitability for future employment or service with that prospective employer; and to
•
this information being disclosed to any Australian law enforcement agency for use for their respective law
enforcement purposes including the investigation and
prosecution of criminal offences.
NOTES
•
The nature of employment suitability assessments and security clearance vetting is such that it cannot be
determined from the outset how many, and to what extent, checks and enquiries will need to be made in
order to be able to make an informed and reasoned a
ssessment about a person’s suitability. For that reason
the General Consent Form cannot specify exactly what specific checks or enquiries will be made for each
security clearance and your general consent to make
all relevant inquiries and checks is sought.
•
However, you are advised that in all cases the following checks will be made:
o
corroboration of any previous Commonwealth employment, including with the Defence Force, and
checks of any existing security records;
o
corroboration of personal history for a minimum of 10 years;
o
corroboration of overseas travel;
o
checks for bankruptcy and of credit history; and
o
criminal record checks.
•
Any or all of (but not limited to) the following checks and enquiries may be made on a needs basis:
o
checks to verify the authenticity and validity of personal and identity documents;
o
check of education documentation with relevant school, college, university and the like;
o
corroboration of overseas travel with Immigration records;
o
enquiries with banks, building societies, credit
unions and others with whom you have financial
dealings;
o
enquiries with current or previous employers about your general character, reliability, trustworthiness,
any disciplinary, conduct or criminal matters in relation to your employment, or any other matter
considered relevant to the assessment of your su
itability;
o
enquiries with friends, relatives and associates about your general character, reliability, trustworthiness
etc;
o
checks of online search information and social media relating to you; and
o
checks or enquiries with any other persons, agencies or organisations which may be able to contribute
information
T re
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FI. ED
AND RELEASED IN ACCORDANCE WITH THE
FREEDOM OF INFORMATION ACT 1982
Printed Name: ....................................... Signature: ………………………………... Date:
(COMMONWEALTH)
EFFECT OF NON–DISCLOSURE
BY THE AUSTRALIAN FEDERAL POLICE
Provision of information is voluntary. A failure to furnish al or part of the information requested may, however, prevent completion
of the request for security clearance or access.
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