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STATE OF ARIZONA Janet Napolitano Governor Structural Pest Control Commission Lisa Gervase Executive Director 9535 E. Doubletree Ranch Road Scottsdale, Arizona 85258-5514 (602) 255-3664 - (602) 255-1281 fax www.sb.state.az.us Applicants with Criminal Conviction(s) Supplement The applicants with Felony conviction(s) must provide the following information for Commission Review. Completed Application for Licensure or License Renewal on the correct form, including all applicable fee(s). Completed Conviction Disclosure Form A complete copy of the Sentencing Orders. A complete copy of the Pre-Sentence Report. If the Pre-Sentence Report is unavailable, please submit a complete copy of the Original Police Report. If on Parole or Probation, a letter from your Parole or Probation Officer indicating your current status. If Parole or Probation has been successfully completed, a complete copy of your Order of Discharge from Probation or Parole. Background investigation, conducted through fingerprinting. Fingerprints must be submitted to the Structural Pest Control Commission. Letters of Recommendation (optional) - providing information about your character, both personal & professional, signed & dated. Please provide contact information for each letter of recommendation The applicants with misdemeanor conviction(s) must provide the following information for Commission Review. Completed Application for Licensure or License Renewal on the correct form, including fee(s) Completed Criminal Conviction Disclosure Form Typed and detailed explanation of the events that lead to the conviction(s), the terms of the conviction(s), the disposition of the conviction(s), and the current status of the applicant All Convictions must be disclosed. An offense that is undesignated, or has been expunged, is still considered a conviction. Failure to disclose all convictions may result in denial of licensing. See Substantive Policy Statement: POLICY NUMBER 2004-002 for additional details at www.sb.state.az.us in the Frequently Used Link – Policies. When all required information is received, your application will be placed on the next available Commission Meeting Agenda for disposition. You will be notified of the time and place of the Commission Meeting. If you have any questions, please telephone the Structural Pest Control Commission Licensing Department at (602) 255-3664. Thank you. Persons with disabilities may request reasonable accommodations by contacting the SPCC ADA Coordinator at (602) 255-3664. Requests should be made as early as possible to allow time to arrange the accommodation. 10/17/2006 - RLT STATE OF ARIZONA Janet Napolitano Governor Structural Pest Control Commission Lisa Gervase Executive Director 9535 E. Doubletree Ranch Road Scottsdale, Arizona 85258-5514 (602) 255-3664 - (602) 255-1281 fax www.sb.state.az.us Criminal CONVICTION DISCLOSURE FORM* (Please type or print clearly) In accordance with Arizona Revised Statutes [32-2312, 32-2314, 32-2315] and Arizona Administrative Code [R4-29-201], the following information must be provided for Commission Review. Full Legal Name: _____________________________________________ Telephone #: (_______) _________ - _________ Mailing Address: ___________________________________________ City: ______________State: ________ZIP: ________ Physical Address: __________________________________________ City: ______________State: ________ZIP: ________ Date of Birth: ________/________/________ Social Security Number: _________ - _________ - ____________ The Charge(s) for which you were convicted: _______________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ The Date(s) of the conviction(s): __________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ The Jurisdiction(s) where the conviction(s) occurred: _________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ The Disposition(s)/ Outcome(s) of the conviction: __________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ Your Current Status (i.e. parole, probation, etc.): __________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ *All Criminal Convictions (Misdemeanor and/or Felony) must be disclosed. Use additional sheets if necessary. An offense that is undesignated, or has been expunged, is still considered a felony conviction. The commission may require submission of a full set of fingerprints pursuant to A.R.S. § 32-2304 (B2). Failure to disclose all convictions may result in denial of licensing. I hereby make the above statement to the Arizona Structural Pest Control Commission as a statement of fact of the official record as a true and correct statement. Signature: ___________________________________________________________________ Date: __________________ Persons with disabilities may request reasonable accommodations by contacting the SPCC ADA Coordinator at (602) 255-3664. Requests should be made as early as possible to allow time to arrange the accommodation. 10/17/2006 - RLT INFORMATION ON FINGERPRINT CARDS AND FINGERPRINTING SERVICES Arizona Revised Statute § 32-2304 (B)(2) – The Commission May: Require a person who seeks a license pursuant to this chapter to submit to the commission a full set of fingerprints and the fees required by section 41-1750. The commission shall submit the fingerprints and fees to the department of public safety for the purpose of obtaining a state and federal criminal records check pursuant to section 41-1750 and Public Law 92-544. The department of public safety may exchange this fingerprint data with the federal bureau of investigation. Fingerprint Card: Only use the blue-outlined, matte finish fingerprint card provided by the SPCC. All spaces must be completed in BLACK INK ONLY. Be sure the information is within the allotted space and not over the line. You must clearly print all information on the card except for the signature. Do not place any information in the boxes labeled Employer & Address and Reason Fingerprinted. Fingerprints which are smeared, too dark, too light, or are generally illegible and which cannot be read or processed by the FBI will be rejected and returned, and you will be required to submit another set of fingerprints. Do not bend or fold the fingerprint card in any way. If the card has been folded or bent, it will be rejected. Also, do not use a highlighter pen anywhere on the card, as the FBI will reject all cards that contain highlighter markings. We recommend you review your Fingerprint card for completeness and fingerprint quality. Refer to the reverse side of the fingerprint card, which outlines FBI standards of readable prints. Fingerprinting Services: The following is a partial list of organizations, firms and individuals who offer fingerprinting services. The Arizona Structural Pest Control Commission does not regulate fingerprinting services and does not attest to the quality of services provided. We strongly suggest that you contact the fingerprints organization, firm, or individual to inquire about the cost, business hours, restrictions, and information or documents you may be required to bring with you. You may be required to take a photograph for purposes of confirming identity. You may be required to make an appointment. Continued on next page Arizona Structural Pest Control Commission 9535 E. Doubletree Ranch Rd. Scottsdale, AZ 85258 – 5514 (602) 255-3664 (602) 255-1281 fax www.sb.state.az.us 10/17/2006 - RLT FINGERPRINTING SERVICES Police Departments Police Departments Arizona County Offices Apache Junction Police Dept. Bullhead City Police Dept. Cochise County Jail 1001 N. Idaho Rd, Apache Junction 1255 Marina Blvd, Bullhead City 203 N. Judd Drive, Bisbee 480-982-8260 928-763-9200 520-384-7070 Avondale Police Dept. Douglas Police Dept. Coconino County Sheriff Office 519 E. Western Avenue, Avondale 300 West 14, Douglas 211 N. Ages, Flagstaff 623-932-3660 928-364-8422 928-774-4523 Chandler Police Dept. Flagstaff Police Dept. Gila County Sheriff Office 250 E. Commonwealth, Chandler 120 N. Beaver Street, Flagstaff 1100 South, Globe 480-782-4130 928-558-2316 928-425-4449 Peoria Police Dept. Town of Marana Police Dept. Maricopa County Sheriff Office 8343 W. Monroe Street, Peoria 13291 N. Lon Adams, Marana 101 W. Madison St., Phoenix 623-773-8311 520-682-4466 602-876-1070 Phoenix Police Dept. Oro Valley Police Dept. Mojave County Sheriff Office 620 W. Washington Street, Phoenix 11000 N. La Canada Drive, Oro Valley 415 E. Pine, Kingman 602-262-6134/ 602-262-6116 520-229-4900 928-718-5548 Scottsdale Police Dept. Parker Police Dept. Pima County Sheriff Office 9065 E. Via Linda, Scottsdale 1314 W. 11th Street, Parker 1650 E. Benson Highway 480-391-5000 928-669-2264 928-741-4971 Tempe Police Dept. Payson Police Dept. Yavapai County Sheriff Office 120 E. Fifth Street, Tempe 303 N. Beeline Highway, Payson 255 E. Gurley St., Prescott 480-858-2024 928-474-5177 520-771-3260 Tucson Police Dept. University of Arizona Police Dept. Yuma County Sheriff Office 1100 S. Alvernon, Tucson 1852 E. First, Tucson 141 S. 3rd Avenue, Yuma 520-791-4697 520-621-8273 928-785-4411 Buckeye Police Dept. Yuma Police Dept. 1001 N. Apache Road, Buckeye 1500 S. 1st Avenue, Yuma 623-386-4421 928-783-4421 OTHER FINGERPRINTING SERVICES A-1 Immigrant Service, Inc. Preferred Information Services Design Photography 2540 E. Thomas Rd. Ste A-B, Phoenix 54 S. Center St., Mesa 1615 N. Wilmot Rd., Tucson 602-977-2612 FAX: 602-952-9757 480-835-6676 520-298-7007 Nuwest Investigations Frontier Private Process Service Adult/ Child Identification 5717 W. Glendale Ave., Glendale 1145 W. McDowell Rd., Phoenix 3121 N. Conestoga Ave., Tucson 623-937-9676 or 602-757-5396 602-258-0022 520-749-4417 Affiliated Fingerprint Consultants Thumbs Up Fingerprint Services Global Investigations 4132 N. 12th St., Phoenix Central/ Northwest Valley – Mobile Svc 7807 E. Greenway # 9, Scottsdale 602-980-7829 / 602-230-1540 623-979-2055 480-443-0828 Community Wellness & Safety of AZ Southwest Fingerprint Labs, Inc. Gilbert/ Tempe (ASU) Higley, AZ 480-892-4295 480-988-1673 Arizona Structural Pest Control Commission 9535 E. Doubletree Ranch Rd. Scottsdale, AZ 85258 – 5514 (602) 255-3664 (602) 255-1281 fax www.sb.state.az.us 10/17/2006 - RLT ARIZONA STRUCTURAL PEST CONTROL COMMISSION SUBSTANTIVE POLICY STATEMENT POLICY NUMBER 2004-002 Pursuant to A.R.S. § 41-1001(20), this substantive policy statement provides the SPCC's approach to, or opinion of, the requirements of SPCC statues, A.R.S. §§ 32-2312(A) and 32-2314(A), and the SPCC's current practice, procedure or method of action based upon this approach or opinion. This is advisory only. A.R.S. §§ 32-2312(A) and 32-2314(A) read: 32-2312. Applicator licenses; application; categories; renewal; inactive licenses A. An application for an applicator license shall be in a form prescribed by the commission and accompanied by the prescribed fee. The application shall set forth whether the applicant has ever been convicted of a felony and, if so, the nature of the felony, when and where it was committed and the disposition of the conviction. D. An applicator shall be of good moral character. 32-2314. Qualifying party; license; examination; inactive status; temporary license A. An application for a qualifying party license shall be in a form prescribed by the commission and accompanied by the prescribed fee. The application shall set forth whether the applicant has ever been convicted of a felony and, if so, the nature of the felony, when and where it was committed and the disposition of the conviction. C. .3 An applicant for qualify party licensure shall: Be of good moral character. This policy statement applies when the SPCC is deciding whether to grant a license to an applicant who has been convicted of a felony or crime involving moral character. A. The SPCC likely will deny licenses to applicants who have been convicted of the following crimes, but each application is considered on its own merits: 1. First or Second Degree Murder 2. A Dangerous Crime Against a Child, including: sexual abuse, aggravated assault, molestation, kidnapping, child abuse, murder, prostituting a child, attempted murder. 3. Sexual Assault-related Offenses 4. Aggravated Manslaughter 5. Rape 6. Kidnapping 7. Trafficking in illegal drugs 8. Crimes involving moral turpitude (i.e.: dishonesty, theft, fraud, falsification) B. The SPCC may deny licenses to applicants who have been convicted of the following felonies: 1. Arson 2. Burglary 3. Theft/Fraud/Falsification type offenses 4. Aggravated or Armed Robbery 5. Assault or Aggravated Assault 6. Domestic violence related offenses 7. Substance abuse related offenses 8. Other C. The SPCC may deny licenses to applicants who do not truthfully answer the felony question on an application or renewal. D. The SPCC may make the following inquiries when determining whether to grant licenses to applicants who have been convicted of crimes; as relevant to the particular offense involved: 1. When did the offense occur? 2. What led to the offense being committed? 3. Was the conviction less than five years before the date of the application? 4. Was a weapon involved in the offense? 5. Was a minor involved as a victim? 6. Was this a crime involving elder abuse? 7. Are there any outstanding fines, restitution, or other terms of criminal probation? 8. Was the conviction of an "aggravated" offense? If so, why? (i.e.: an "aggravated DUI" generally means that there were prior DUI convictions within a short time). 9. If the applicant was sentenced to prison, was the applicant released less than three years before the date of the application? 10. Was the applicant convicted of any other felonies or crimes involving moral turpitude? 11. Was alcohol or drugs involved? 12. Did the offense occur in/around a school, church, private home? 13. Is the applicant still on probation (release of a defendant to the supervision of the county??)? 14. Was the applicant placed on "intensive" probation? If so, this generally means that the applicant failed to comply with prior terms of their sentence or probation. 15. Is the applicant still on parole (release of a defendant to the supervision of the state??)? 16. Does the applicant currently use alcohol/drugs? 17. If the offense was alcohol/drug related, what rehabilitation has occurred? 18. Was the applicant's offense/offenses plea-bargained to lesser charges? 19. Has the applicant received anger management, alcohol/drug counseling? 20. Employment history? 21. Educational background? 22. Support systems? 23. How old was applicant when committed offense(s)? 24. What is applicant's current employment? Pursuant to A.R.S. §41-1013(B)(14) and A.A.C. §R1-1-210, this substantive policy statement shall be filed with the Arizona Secretary of State and published in the Arizona Administrative Register.
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