Blank Ohio Hls 0037 PDF Form

Blank Ohio Hls 0037 PDF Form

The Ohio HLS 0037 form is a declaration required by the Ohio Department of Public Safety that addresses material assistance or non-assistance to terrorist organizations. This form is crucial for public employment applications, ensuring that individuals disclose any connections to groups identified on the U.S. Department of State Terrorist Exclusion List. Completing this form accurately is essential, and you can begin the process by clicking the button below.

The Ohio HLS 0037 form plays a critical role in public employment processes within the state. It is designed to ensure that individuals applying for public positions do not have any connections to terrorist organizations as identified by the U.S. Department of State. This declaration requires applicants to answer a series of questions regarding their affiliations and actions related to such organizations. A simple “yes” to any question can indicate potential material assistance to a terrorist group, which could have serious legal implications. The form outlines what constitutes "material support or resources," including financial contributions, training, and various forms of assistance. It is essential for applicants to provide truthful responses, as any misleading information can lead to felony charges. Furthermore, if a public employment application is denied based on the information provided, there is a process for review through the Ohio Department of Public Safety’s Division of Homeland Security. Understanding the importance of this form is crucial for anyone seeking public employment in Ohio.

Document Sample

Ohio Department of Public Safety

Division of Homeland Security

http://www.homelandsecurity.ohio.gov

PUBLIC EMPLOYMENT

In accordance with section 2909.34 of the Ohio Revised Code

DECLARATION REGARDING MATERIAL ASSISTANCE/NONASSISTANCE TO A TERRORIST ORGANIZATION

This form serves as a declaration of the provision of material assistance to a terrorist organization or organization that supports terrorism as identified by the U.S. Department of State Terrorist Exclusion List (see the Ohio Homeland Security Division website for a reference copy of the Terrorist Exclusion List).

Any answer of “yes” to any question, or the failure to answer “no” to any question on this declaration shall serve as a disclosure that material assistance to an organization identified on the U.S. Department of State Terrorist Exclusion List has been provided. Failure to disclose the provision of material assistance to such an organization or knowingly making false statements regarding material assistance to such an organization is a felony of the fifth degree.

For the purposes of this declaration, “material support or resources” means currency, payment instruments, other financial securities, funds, transfer of funds, and financial services that are in excess of one hundred dollars, as well as communications, lodging, training, safe houses, false documentation or identification, communications equipment, facilities, weapons, lethal substances, explosives, personnel, transportation, and other physical assets, except medicine or religious materials.

LAST NAME

 

 

 

FIRST NAME

 

 

 

MIDDLE INITIAL

 

 

 

 

 

 

 

 

 

HOME ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

 

STATE

 

ZIP

COUNTY

 

 

 

 

 

 

 

 

HOME PHONE

 

 

WORK PHONE

 

 

(

)

 

(

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DECLARATION

In accordance with division (A)(2)(b) of section 2909.32 of the Ohio Revised Code

For each question, indicate either “yes,” or “no” in the space provided. Responses must be truthful to the best of your knowledge.

1.Are you a member of an organization on the U.S. Department of State Terrorist Exclusion List? Yes No

2.Have you used any position of prominence you have with any country to persuade others to support an organization on the U.S. Department of State Terrorist Exclusion List?

Yes No

3.Have you knowingly solicited funds or other things of value for an organization on the U.S. Department of State Terrorist Exclusion List?

Yes No

HLS 0037 2/06

PUBLIC EMPLOYMENT - CONTINUED

4.Have you solicited any individual for membership in an organization on the U.S. Department of State Terrorist Exclusion List?

Yes No

5.Have you committed an act that you know, or reasonably should have known, affords "material support or resources" to an organization on the U.S. Department of State Terrorist Exclusion List?

Yes No

6.Have you hired or compensated a person you knew to be a member of an organization on the U.S. Department of State Terrorist Exclusion List, or a person you knew to be engaged in planning, assisting, or carrying out an act of terrorism?

Yes No

In the event of a denial of public employment due to a positive indication that material assistance has been provided to a terrorist organization, or an organization that supports terrorism as identified by the U.S. Department of State Terrorist Exclusion List, a review of the denial may be requested. The request must be sent to the Ohio Department of Public Safety’s Division of Homeland Security. The request forms and instructions for filing can be found on the Ohio Homeland Security Division website.

CERTIFICATION

I hereby certify that the answers I have made to all of the questions on this declaration are true to the best of my knowledge. I understand that if this declaration is not completed in its entirety, it will not be processed and I will be automatically disqualified. I understand that I am responsible for the correctness of this declaration. I understand that failure to disclose the provision of material assistance to an organization identified on the U.S. Department of State Terrorist Exclusion List, or knowingly making false statements regarding material assistance to such an organization is a felony of the fifth degree. I understand that any answer of “yes” to any question, or the failure to answer “no” to any question on this declaration shall serve as a disclosure that material assistance to an organization identified on the U.S. Department of State Terrorist Exclusion List has been provided by myself or my organization.

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Signature

Date

File Specifics

Fact Name Description
Governing Law This form is governed by section 2909.34 of the Ohio Revised Code.
Purpose The form serves as a declaration regarding material assistance to terrorist organizations.
Terrorist Exclusion List It references the U.S. Department of State Terrorist Exclusion List for identifying organizations.
Disclosure Requirement A "yes" answer to any question indicates disclosure of material assistance provided.
Legal Consequences Failure to disclose or making false statements is classified as a felony of the fifth degree.
Definition of Material Support Material support includes financial resources, training, and other physical assets, excluding medicine or religious materials.
Employment Denial Review Individuals can request a review if denied public employment due to a positive indication of assistance.
Certification Requirement Signatories must certify the truthfulness of their answers on the declaration.

How to Use Ohio Hls 0037

Completing the Ohio HLS 0037 form is a straightforward process that requires careful attention to detail. This declaration is essential for public employment and must be filled out accurately to avoid any potential disqualifications. Below are the steps to guide you through the completion of the form.

  1. Begin by entering your last name in the designated space at the top of the form.
  2. Next, fill in your first name and middle initial in the appropriate fields.
  3. Provide your home address, ensuring to include the street number and name.
  4. Indicate your city, state, and ZIP code in the respective sections.
  5. List your county of residence.
  6. Enter your home phone number, followed by your work phone number in the provided spaces.

Once you have filled in your personal information, proceed to the declaration section. This part consists of several questions that require a truthful response.

  1. For each question, respond with either “yes” or “no” by marking the appropriate box.
  2. Questions will inquire about your affiliations and actions regarding organizations on the U.S. Department of State Terrorist Exclusion List.
  3. Ensure you answer all six questions honestly, as any affirmative response or failure to answer will be considered a disclosure of material assistance.

After completing the declaration, you will need to certify your answers. This is a crucial step.

  1. Sign the form in the designated area to confirm that your answers are true to the best of your knowledge.
  2. Finally, date the form to indicate when you completed it.

Upon finishing, review the form to ensure all sections are filled out completely. Incomplete forms will not be processed, leading to disqualification from public employment. Once verified, submit the form as instructed on the Ohio Department of Public Safety’s website.

Your Questions, Answered

What is the purpose of the Ohio HLS 0037 form?

The Ohio HLS 0037 form is designed to collect declarations regarding any material assistance provided to terrorist organizations, as defined by the U.S. Department of State's Terrorist Exclusion List. This form plays a crucial role in ensuring that individuals seeking public employment disclose any affiliations or actions that may pose a security risk. By answering the questions truthfully, applicants help maintain the integrity of public service positions.

What happens if I answer "yes" to any of the questions on the form?

If you answer "yes" to any question on the Ohio HLS 0037 form, it indicates that you have provided material assistance to an organization listed on the U.S. Department of State Terrorist Exclusion List. This response serves as a disclosure and may lead to disqualification from public employment. Additionally, failure to answer "no" to any question is treated similarly. It is essential to approach this form with honesty, as any misrepresentation can have serious legal consequences.

What constitutes "material support or resources" according to the form?

"Material support or resources" encompasses a wide range of items and services. Specifically, it includes:

  • Currency and financial instruments exceeding one hundred dollars
  • Financial services and funds transfers
  • Communications equipment and facilities
  • Training, safe houses, and false documentation
  • Transportation and personnel
  • Weapons and explosives

However, it is important to note that medicine or religious materials are excluded from this definition. Understanding what qualifies as material support is crucial for accurately completing the form.

What should I do if my application for public employment is denied?

If your application for public employment is denied due to a positive indication of providing material assistance to a terrorist organization, you have the right to request a review of that denial. To initiate this process, you must submit a request to the Ohio Department of Public Safety’s Division of Homeland Security. Detailed instructions and necessary forms for filing this request can be found on the Ohio Homeland Security Division website. It is advisable to act promptly to ensure your appeal is considered.

Common mistakes

  1. Failing to answer all questions: Each question on the form must be answered. Leaving any question blank can lead to automatic disqualification.

  2. Providing inaccurate information: All answers must be truthful. Providing false information is a serious offense and can lead to legal consequences.

  3. Misunderstanding the definition of material support: Ensure you understand what constitutes "material support or resources." This includes financial contributions, training, and other forms of assistance.

  4. Ignoring the Terrorist Exclusion List: Familiarize yourself with the U.S. Department of State Terrorist Exclusion List. Not doing so may lead to unintentional disclosures.

  5. Not certifying the declaration: Remember to sign and date the form. Certification indicates that you acknowledge the truthfulness of your answers.

  6. Overlooking the consequences of a "yes" answer: A "yes" answer to any question indicates potential material assistance. Understand the implications before submitting your responses.

  7. Neglecting to keep a copy: Always retain a copy of your completed form for your records. This can be crucial for future reference or if you need to contest a denial of employment.

Documents used along the form

The Ohio HLS 0037 form is a crucial document for individuals applying for public employment in Ohio. It serves as a declaration regarding any material assistance provided to terrorist organizations as defined by the U.S. Department of State. Alongside this form, there are several other documents that may be required or beneficial during the application process. Below is a list of these forms and documents, each with a brief description.

  • Background Check Authorization Form: This document allows the employer to conduct a thorough background check on the applicant. It typically includes consent for checking criminal records, employment history, and other relevant information.
  • Employment Application: This is a standard form that collects personal information, work history, and qualifications of the applicant. It provides a comprehensive overview of the candidate's background and suitability for the position.
  • Affidavit of Identity: This sworn statement verifies the identity of the applicant. It may be required to confirm that the individual is who they claim to be, particularly in sensitive positions.
  • Declaration of Citizenship: This form is used to affirm the citizenship status of the applicant. It is essential for compliance with federal and state employment laws, especially for public positions.
  • Release of Information Form: This document grants permission for the employer to obtain information from previous employers or other sources. It facilitates the verification of the applicant's work history and qualifications.
  • Request for Review Form: If an applicant is denied employment based on the HLS 0037 form, this document allows them to formally request a review of that decision. It ensures that individuals have a pathway to contest unfavorable outcomes.

Each of these documents plays a significant role in the public employment application process in Ohio. Ensuring that all forms are completed accurately and submitted on time can help facilitate a smooth hiring process. Understanding the purpose of each document will empower applicants to navigate their responsibilities effectively.

Similar forms

The Ohio HLS 0037 form shares similarities with the Federal Form I-9, which is used for verifying the identity and employment authorization of individuals hired for employment in the United States. Both forms require individuals to provide truthful information about their background and affiliations. The I-9 form includes questions about citizenship status and requires supporting documents to establish identity, similar to how the HLS 0037 requires declarations regarding affiliations with terrorist organizations. Both forms emphasize the importance of accuracy and honesty, with potential legal consequences for false statements.

Another document that resembles the Ohio HLS 0037 is the U.S. Department of State's DS-5535, which is the "Supplemental Questions for Visa Applicants." This form collects additional information about visa applicants to assess potential security risks. Like the HLS 0037, the DS-5535 asks about affiliations and activities that could indicate support for terrorism. Both documents serve as tools to protect national security by ensuring that individuals with questionable backgrounds are thoroughly vetted before being granted access to public employment or entry into the United States.

The FBI's SF-86, or "Questionnaire for National Security Positions," is another comparable document. This form is used during the security clearance process and requires individuals to disclose personal, professional, and financial information. Similar to the HLS 0037, the SF-86 asks about affiliations with organizations that may pose a security threat. Both forms are designed to identify potential risks and ensure that individuals in sensitive positions do not have ties to groups that could compromise national security.

The U.S. Citizenship and Immigration Services (USCIS) Form N-400, the application for naturalization, also shares commonalities with the HLS 0037. The N-400 requires applicants to demonstrate good moral character and allegiance to the United States. It includes questions about associations with organizations that advocate for violence or terrorism, paralleling the inquiries made in the HLS 0037. Both forms aim to ensure that individuals seeking employment or citizenship have a commitment to the values and security of the nation.

The Department of Defense's Standard Form 86 (SF-86) is another relevant document. This form is utilized for background checks on individuals seeking access to classified information. Like the HLS 0037, the SF-86 includes questions about affiliations with extremist groups and requires full disclosure of any potential risks. Both forms are integral to maintaining security within sensitive positions and ensuring that individuals do not pose a threat to national safety.

The Ohio Bureau of Criminal Investigation (BCI) background check form is also similar to the HLS 0037. This form is used to assess the criminal history of individuals applying for certain jobs, particularly in public service. Both documents require applicants to disclose relevant information that could impact their eligibility for employment. The emphasis on transparency and the consequences of providing false information are common themes, reinforcing the importance of integrity in the hiring process.

Lastly, the IRS Form 4506-T, which is a request for tax return transcripts, can be compared to the HLS 0037 in terms of its verification purpose. While the IRS form focuses on financial history, both forms require individuals to provide accurate information about their activities and affiliations. Each form serves as a means of ensuring that individuals are compliant with legal standards, whether in the context of employment or tax obligations.

Dos and Don'ts

When filling out the Ohio HLS 0037 form, follow these guidelines to ensure accuracy and compliance.

  • Do read the entire form carefully before starting.
  • Do answer all questions truthfully and to the best of your knowledge.
  • Do provide your full name and accurate contact information.
  • Do check the U.S. Department of State Terrorist Exclusion List if unsure about any organizations.
  • Do sign and date the form upon completion.
  • Don't leave any questions unanswered; this will lead to disqualification.
  • Don't provide false information; this can result in felony charges.
  • Don't assume that a “no” answer is sufficient without confirming your knowledge of the organization.
  • Don't submit the form without reviewing it for accuracy.
  • Don't hesitate to seek clarification from the Ohio Department of Public Safety if needed.

Misconceptions

Here are four common misconceptions about the Ohio HLS 0037 form:

  • Misconception 1: The form is only for individuals directly involved with terrorist organizations.
  • This is not true. The HLS 0037 form applies to anyone who may have unknowingly provided support or resources to a terrorist organization, even if they are not directly involved.

  • Misconception 2: Answering "yes" to any question automatically results in criminal charges.
  • While answering "yes" indicates that material assistance may have been provided, it does not automatically lead to charges. The form is a declaration that helps assess eligibility for public employment.

  • Misconception 3: The form only requires a signature to be valid.
  • In fact, the form must be completed in its entirety. Incomplete forms will not be processed, and individuals will be disqualified from public employment opportunities.

  • Misconception 4: It is safe to leave questions unanswered if unsure.
  • Leaving questions unanswered is not advisable. The form requires a response to each question. Failing to answer can lead to disqualification, as it is treated as a failure to disclose.

Key takeaways

When filling out the Ohio HLS 0037 form, it’s important to keep several key points in mind. This form is essential for public employment and serves as a declaration regarding material assistance to terrorist organizations. Here are some takeaways to consider:

  • Understand the Purpose: The form is designed to disclose any material assistance to organizations on the U.S. Department of State Terrorist Exclusion List.
  • Be Honest: All answers must be truthful. A “yes” response to any question indicates that material assistance may have been provided.
  • Know the Consequences: Failing to disclose assistance or providing false information can lead to serious legal repercussions, including felony charges.
  • Material Support Defined: Material support includes a wide range of resources, such as financial assistance, training, or transportation, but excludes medicine and religious materials.
  • Review Process: If public employment is denied due to a positive indication of assistance, you can request a review of the denial from the Ohio Department of Public Safety’s Division of Homeland Security.
  • Complete the Form Fully: Incomplete forms will not be processed, leading to automatic disqualification from public employment opportunities.

By keeping these points in mind, individuals can navigate the process of filling out the Ohio HLS 0037 form more effectively and responsibly.