Blank Dos 1246 PDF Form

Blank Dos 1246 PDF Form

The DOS 1246 form is a renewal application for security guards in New York State, designed to ensure that individuals maintain their eligibility to work in this vital role. This form requires applicants to provide updated personal information, confirm compliance with training requirements, and affirm their legal standing regarding child support obligations. To begin the renewal process, please fill out the form by clicking the button below.

The DOS 1246 form is a crucial document for individuals seeking to renew their security guard registration in New York State. This form requires applicants to provide updated personal information, including their name and address, along with a $25 renewal fee. Additionally, it includes essential questions regarding any criminal convictions, pending charges, or issues related to child support obligations. These inquiries ensure that applicants meet the necessary legal standards for maintaining their security guard status. Furthermore, the form mandates that applicants complete specific training courses, such as the 16-hour On-The-Job training and the 8-hour Annual In-Service training, to remain compliant with state regulations. It’s important to note that failure to submit the completed form and required documentation on time may result in the inability to work as a security guard, as well as the need to reapply and requalify if the registration lapses for more than six months. Understanding the requirements and instructions laid out in the DOS 1246 form is essential for a smooth renewal process.

Document Sample

SECURITY GUARD RENEWAL

SEE INSTRUCTIONS ON BACK

 

 

 

 

 

PRINT ANY CHANGES IN INK IN THIS AREA

 

Unique ID Number

YOUR NEW LAST NAME

FIRST NAME

Ml

SUFFIX

$25.00

 

 

 

 

 

 

 

Fee Due

NEW HOME STREET ADDRESS (NUMBER STREET)

NEW HOME STREET CONTINUED

Current Term Expires:

1)Yes 0 No [i

2)i-7 No f

Yes LJ

3)Yes [1 No [i

NEW HOME CITY

STATE ZIP CODE+ 4 CNTY

Since your last application, have you been convicted of a crime or offense (not minor traffic violation), in this state or elsewhere? (If Yes, please enclose court disposition.)

Since your last application has any license, permit, commission, registration or application for a license, permit, commission or registration held by or submitted by you or a company in which you are or were a principal been revoked. suspended, or denied by any state, territory or governmentaljurisdiction or foreign country for any reason? (If Yes, enclose details).

Are there any criminal charges (misdemeanor or felony) pending against you in any court in this state or elsewhere? (If Yes, you must submit a copy of the accusatory instrument e.g. indictment, criminal information or complaint).

Notice:

Prier to renewal you must complete mandatory training (see instructions on reverse side ofform.) Our records show the following training is currently on flJe:

OJT:

Annual Training:

Annual Training:

OJTtraining is required of any guard employed for more than 90 days. If any of the above dates for annual training are missing, you must complete that training prior to submission ofyour renewal form.

Child Support Statement:

By signing this application. I certify that as of the d ate of this application. I am not under an obligation to pay child support OR if I am under an obligation to pay child support, I am not four or more months in arrears in the payment of child support, or I am making payments by income execution or by court agreed payment or repayment plan or by plan agreed to by the parties or my child support obligation is the subject of a pending court proceeding, or I am receiving public assistance or I am receiving public assistance or supplemental security income.

Applicant Affirmation:

I affirm. under the penalities of perjury. that the statements made in this application are true and correct.

In addition. I hereby autl1orize the t�YS Department of State and NYS Departmentof Motor Vehicles to produce an 1D card bearing my OMV photo. understand that DOS and DMV will use my DMV phto to produce all subsequent ID Cards for as long as I maintain my license with the Department of

State.

Applicant Signature

 

 

Date

 

 

 

 

 

 

Complete For Credit Card Payment

 

 

 

Applicant's Unique ID Number:

..-

Total amount due: $ ________

Master Card

 

Applicant's Name:

 

 

 

Please charge to the following credit card:

Visa

I

 

I

 

Credit Card NO:

_I�1_1 �II� I___ I I

I

I I I I

I

I I I

Exp. Mo

Yr.

 

 

 

 

 

 

 

Print cardholder's name:

Cardholder's signature:

Date:

DOS -1246 Security Guard (Rev.5/14)

NYS DEPARTMENT OF STATE

DIVISION OF LICENSING SERVICES

PO BOX 5004, G.P.O.

NEW YORK, NY 10087-5004

Instructions:

1Answer all application questions and sign the Affirmation. Your renewal will not be processed without all of this information.

2Check the preprinted information (top left) and enter any changes in the space at right. It is important that you notify this Division of any changes to your residential address so you continue to receive renewal notices and any other notifications pertinent to your registration.

NOTE: If your name has changed (including changes due to marital status), please indicate the changes in the spaces to the right of the preprinted information. You must provide proof of such change of name, e.g., a copy of one of the following:

Court order changing your name Marriage certificate

Driver's license, or a non-driver's ID card Valid passport

Immigration documents

Child Support Statement

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A Child Support

 

Statement

 

is

mandatory

in

New

York

State

(General

Obligations

Law).

The law requires you

to

complete

this

 

section

-

regardless

of

whether

or

 

not

you

have

children

or

any

support

obligation.

Any

person

who

Is four months

or

more

in

arrears

in

child

support may

be

subject

to

having his

or

 

her

 

business,

professional and driver's licenses suspended. The

 

intentional

submission

of

a false written statement for the purpose of frustrating or

defeating

the

lawful

enforcement

of

support

obligations

is

punishable

under

Section

175.35 of the

Penal Law. It

is

a

class E

felony

 

to

offer

a

false

instrument

 

for

filing

with

a

state or

local government

with the

intent to defraud.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Training Requirements

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

It you are not In compliance with these training requirements, you

 

 

 

may not submit this renewal form.

 

 

 

 

 

 

 

 

 

 

 

 

In order to renew your registration, the required training courses must

 

 

be completed and on file with our office. The reverse side of this

 

 

 

 

application displays your training currently on file wtth our office. The

 

 

 

following courses are required:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

16-Hour On-The Job(OJT) - renewal form must display date if

 

 

 

 

 

employed for over 90 days.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8-Hour Annual In-Service - must be completed within each

 

 

 

 

 

year of your license term; renewal form must display two

 

 

 

 

 

 

completiondates

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If registered with our office to carry a firearm, you mustalso complete:

 

 

 

8-Hour Annual Firearms Course - must be completed each

 

 

 

 

 

calendar year; renewal form must display two completion dates

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Photo ID Card

 

 

 

 

Warning:

The

Department

of

State will not accept documents with

 

 

 

 

 

alterations

or

 

erasures. Presentation

of

 

fraudulent

documents

may

also

Your photo ID card

will be produced by the

NYS Department of

Motor

 

result

in criminal prosecution.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicles using the image on file in their office.

If you have a valid NYS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

Mail

this

completed,

signed.

original

renewal

notice

wrth

your

$25

Driver License or

Non-Driver ID with photo,

please read the

section

"InformedConsent" on the reverse side of this notice, sign and date tt.

 

nonrefundable

fee.

You may pay by check or money order made

 

 

 

 

 

 

 

payable

to

the

NYS

Department

of

 

State

or

charge any fee

to

Failure to adhere to these instructions will delay

 

 

MasterCard

or

Visa.

A

$20 fee

will

be

charged

for

any

check

 

 

issuance of your new registration.

 

 

-·----------------------

returned by your bank.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

-----------------

 

 

 

--------------------

 

 

Please fold here to ensure the address below * * * DO NOT CUT - PLEASE RETURN

Security Guard Renewal Application

DO NOT DELAY: You cannot work as a security guard if you do not renew your registration by the expiration date of your current registration. Additionally if you do not renew your registration within 6 months after the expiration of your current registration, you will have to reapply and requalify.

appears in the window of the return envelope.

 

ENTIRE FORM FOR PROCESSING * * *

 

 

Questions?

Contact

the Division

of

Licensing

Services

at

(518)

474-7569. Please

reference

your Unique ID Number in all communications.

NYS DEPARTMENT OF STATE

DIVISION OF LICENSING SERVICES

PO BOX 5004, G.P.O. NEWYORK, NY 10087-5004

File Specifics

Fact Name Details
Form Purpose The DOS 1246 form is used for the renewal of security guard registrations in New York State.
Fee Requirement A nonrefundable fee of $25.00 is required to process the renewal application.
Training Requirements Mandatory training must be completed prior to renewal. This includes 16 hours of On-The-Job training and 8 hours of annual in-service training.
Governing Law The form is governed by New York State General Obligations Law, which mandates the completion of the Child Support Statement section.

How to Use Dos 1246

Once you have gathered all necessary documents and information, it’s time to fill out the DOS 1246 form for your security guard renewal. Following these steps will help ensure that your application is complete and processed without delays.

  1. Locate the preprinted information at the top left of the form. Verify that it is correct. If there are any changes, write them in the space provided.
  2. In the section labeled "Unique ID Number," enter your unique identification number.
  3. Fill in your new last name, first name, middle initial, and suffix (if applicable).
  4. Provide your new home street address, including the number and street name. If necessary, continue on the next line.
  5. Enter your new home city, state, and ZIP code.
  6. Indicate whether your current term has expired by checking “Yes” or “No.”
  7. Answer the questions regarding any criminal convictions, license revocations, or pending criminal charges by checking “Yes” or “No.” If you answer “Yes” to any question, be prepared to provide additional documentation.
  8. Complete the Child Support Statement section. Indicate your current status regarding child support obligations.
  9. Sign and date the application in the designated area to affirm the accuracy of your statements.
  10. If paying by credit card, fill in your credit card information, including the cardholder’s name and signature. Make sure to include the total amount due.
  11. Mail the completed form, along with the $25 nonrefundable fee, to the address provided at the bottom of the form.

After submitting your application, keep an eye on your mailbox. If everything is in order, you will receive your new registration in due time. Ensure that you have completed any required training before submitting your form to avoid delays in processing.

Your Questions, Answered

What is the purpose of the DOS 1246 form?

The DOS 1246 form is used for the renewal of security guard registrations in New York State. This form ensures that security guards maintain their licenses by providing updated personal information, confirming compliance with training requirements, and affirming their legal standing regarding child support obligations. It’s essential to submit this form on time to continue working legally as a security guard.

What information do I need to provide on the DOS 1246 form?

When filling out the DOS 1246 form, you will need to provide several key pieces of information:

  1. Your unique ID number and personal details, including your name, address, and any changes to this information.
  2. Details about any criminal convictions or pending charges since your last application.
  3. Confirmation of your completion of mandatory training courses.
  4. A child support statement, affirming your compliance with child support obligations.

Make sure to answer all questions honestly and completely, as incomplete forms can delay the renewal process.

What are the training requirements for renewing my security guard registration?

To renew your registration, you must complete specific training courses. These include:

  • 16-Hour On-The-Job (OJT) training if you have been employed for more than 90 days.
  • 8-Hour Annual In-Service training, which must be completed each year.
  • If you carry a firearm, an additional 8-Hour Annual Firearms Course is required.

Ensure that all training dates are recorded on your renewal form. If any training is missing, you must complete it before submitting your renewal.

What happens if I miss the renewal deadline?

Failing to renew your security guard registration by the expiration date means you cannot legally work as a security guard. If you do not renew within six months after your registration expires, you will need to reapply and requalify for your license. This process can be time-consuming, so it’s best to stay on top of your renewal deadlines.

How do I submit the DOS 1246 form and pay the renewal fee?

You can submit the completed DOS 1246 form by mailing it to the New York State Department of State, Division of Licensing Services. Include a non-refundable fee of $25, which can be paid by check, money order, or credit card. If paying by credit card, ensure you provide all necessary card details on the form. Remember to keep a copy of your submission for your records, and check that your form is signed and complete to avoid delays.

Common mistakes

  1. Failing to answer all application questions. The form will not be processed if any questions are left unanswered.

  2. Not checking the preprinted information for accuracy. Always verify that your Unique ID Number and personal details are correct.

  3. Neglecting to report any name changes. If your name has changed, you must indicate this and provide proof, such as a marriage certificate or court order.

  4. Overlooking the child support statement. This section is mandatory, regardless of your child support obligations.

  5. Failing to complete required training. Ensure that all necessary training courses are completed and recorded before submitting the form.

  6. Not signing the affirmation. Your signature is crucial to certify that the information provided is true and correct.

  7. Using altered or erased documents. Any changes to the form can lead to rejection and possible criminal charges.

  8. Submitting payment incorrectly. Ensure that your payment method is clear and that you include the correct fee to avoid delays.

Documents used along the form

The DOS 1246 form is essential for the renewal of a security guard license in New York State. Along with this form, several other documents may be required to ensure compliance with state regulations. Below is a list of commonly used forms and documents that accompany the DOS 1246 form.

  • Child Support Statement: This document certifies the applicant's current child support obligations. It is mandatory for all applicants and ensures compliance with New York State law regarding child support payments.
  • Proof of Name Change: If the applicant has changed their name since the last application, they must provide documentation such as a marriage certificate, court order, or valid passport to verify the name change.
  • Training Certificates: Certificates proving completion of required training courses, including the 16-Hour On-The-Job training and any annual in-service training, must be submitted. These documents confirm that the applicant has met the training requirements for license renewal.
  • Criminal Record Documentation: If the applicant has been convicted of a crime or has pending criminal charges, they must submit court disposition documents or copies of the accusatory instruments as part of the renewal process.
  • Payment Information: This includes a completed credit card payment form or a check/money order for the renewal fee. Payment must be included with the application to avoid delays.
  • Photo ID: A valid photo identification, such as a New York State Driver License or Non-Driver ID, may be required for identity verification during the renewal process.
  • Application Affirmation: The applicant must sign an affirmation stating that all information provided is true and correct. This affirmation is a critical part of the application process.

Collecting and submitting these documents along with the DOS 1246 form is crucial for a smooth renewal process. Ensure all forms are completed accurately to avoid any delays in obtaining your security guard license renewal.

Similar forms

The DOS 1246 form is similar to the Application for Employment Authorization (Form I-765). Both documents require applicants to provide personal information and affirm their eligibility for a specific status or role. The I-765 form asks for details about any criminal history, similar to the DOS 1246, which inquires about past convictions and current charges. Both forms also necessitate the submission of additional documentation if there are any changes or specific circumstances, such as name changes or pending legal matters.

Another document akin to the DOS 1246 is the Application for a Driver's License or ID Card. This form, like the DOS 1246, requires applicants to provide their current address and personal identification details. Both documents emphasize the importance of accuracy in the information provided, as discrepancies can lead to delays or denials. Furthermore, both forms may require proof of identity or residency, reinforcing the need for valid documentation to support the application.

The Security Guard License Application is another comparable document. This application requires similar personal information and background checks, including questions about criminal history. Both forms are designed to ensure that applicants meet the necessary qualifications for their respective roles. Additionally, they share a common requirement for training documentation, indicating that both roles require specific training to maintain licensure.

The Child Support Statement form is also similar to the DOS 1246. Both documents mandate the disclosure of child support obligations and the consequences of non-compliance. The DOS 1246 includes a section that requires applicants to certify their child support status, while the Child Support Statement focuses solely on obligations. Both forms highlight the legal implications of failing to meet these obligations, emphasizing the importance of compliance in maintaining professional licenses.

The Background Check Authorization form shares similarities with the DOS 1246 in that both require individuals to disclose any criminal history. The DOS 1246 asks about past convictions and pending charges, while the Background Check Authorization form is used to obtain a comprehensive review of an individual’s criminal record. Both documents serve to ensure that applicants for specific roles are vetted thoroughly to maintain safety and compliance with legal standards.

Finally, the Renewal Application for Professional Licenses is comparable to the DOS 1246. Both documents require applicants to provide updated personal information and affirm their qualifications for renewal. They also include questions about any legal issues that may affect the applicant's ability to hold a license. Additionally, both forms require proof of continued education or training, ensuring that applicants remain compliant with industry standards and regulations.

Dos and Don'ts

Filling out the DOS 1246 form can be straightforward if you keep a few key points in mind. Here’s a list of dos and don’ts to help you complete the form correctly.

  • Do read all instructions carefully before starting.
  • Do use blue or black ink when making changes.
  • Do double-check your Unique ID Number for accuracy.
  • Do ensure that all required training is completed and documented.
  • Do sign and date the application to affirm your statements.
  • Don't leave any questions unanswered; provide complete information.
  • Don't forget to include proof of any name changes if applicable.
  • Don't submit altered or erased documents; they will be rejected.
  • Don't ignore the child support statement; it’s mandatory.
  • Don't delay your submission; renew your registration before the expiration date.

By following these guidelines, you can help ensure that your application process goes smoothly and efficiently.

Misconceptions

Here are nine misconceptions about the DOS 1246 form that you should be aware of:

  • Misconception 1: The DOS 1246 form is only for new applicants.
  • This form is specifically for renewing your security guard registration, not for new applications.

  • Misconception 2: I can submit the form without completing mandatory training.
  • You must complete all required training before submitting the renewal form. Failure to do so will result in a denial of your application.

  • Misconception 3: It’s okay to submit the form without providing a child support statement.
  • A child support statement is mandatory, regardless of whether you have any children or obligations.

  • Misconception 4: I can ignore changes to my address or name.
  • It is crucial to update any changes to your address or name on the form to ensure you receive important notifications.

  • Misconception 5: I can work as a security guard while my renewal is pending.
  • You cannot work as a security guard if your registration has expired. Timely renewal is essential.

  • Misconception 6: The fee for renewal is refundable if my application is denied.
  • The $25 renewal fee is nonrefundable, even if your application does not get approved.

  • Misconception 7: I can submit altered documents with my application.
  • Submitting altered documents is not allowed and can lead to criminal prosecution.

  • Misconception 8: I don’t need to provide proof of name changes.
  • If your name has changed, you must provide documentation such as a marriage certificate or court order.

  • Misconception 9: I can submit the application anytime after my registration expires.
  • You must renew your registration within six months after expiration, or you will have to reapply and requalify.

Understanding these misconceptions can help ensure a smoother renewal process for your security guard registration.

Key takeaways

When filling out and using the DOS 1246 form for security guard renewal, it’s essential to follow specific guidelines to ensure a smooth process. Here are six key takeaways to keep in mind:

  • Complete All Sections: Answer every question on the form. Incomplete applications will not be processed.
  • Update Your Information: If there are changes to your name or address, make sure to note them clearly. This helps the Department of State to send you important notifications.
  • Child Support Statement: This statement is mandatory, regardless of whether you have children. Ensure you accurately complete this section to avoid complications.
  • Training Requirements: Confirm that you have completed all necessary training courses. The required training must be on file for your renewal to be accepted.
  • Signature and Affirmation: Don’t forget to sign the application. Your signature affirms that the information provided is true and correct.
  • Submit on Time: Renew your registration before the expiration date. If you miss the deadline, you may need to reapply and requalify.

By keeping these points in mind, you can help ensure that your renewal process goes smoothly and efficiently.