Criminal Record Self-Disclosure Form A Criminal record self-disclosure form A Your details Your Name * Role you’re applying for * Unspent Convictions Do you have any unspent convictions? * Yes No Explanation of what we mean by unspent convictions: Please answer “Yes” if you have any convictions that are not yet spent under the Rehabilitation of Offenders Act 1974. The term ‘convictions’ is used to refer to any sentence or disposal issued by a court. If all your convictions are spent, you can answer “No”. If you’re not sure if your convictions are unspent or spent, you can use a tool available at https://unlock.org.uk/disclosure-calculator/ and read guidance at https://hub.unlock.org.uk/information/rehabilitation-of-offenders-act-1974/ If you have answered Yes, there are three ways to provide us with the details: Provide the offence dates, dates of conviction/caution, offence types and sentences received in the space below. Provide the offence dates, dates of conviction/caution, offence types and sentences received on a separate document and attach this below. Provide the offence dates, dates of conviction/caution, offence types and sentences received on a separate document and send it back to us in an envelope along with confirmation of your name and the role you're applying for. If you are providing details in the post please indicate by ticking the box below. Full Details If you have the details in a separate document, please upload here. Drop a file here or click to upload Choose File Maximum file size: 516MB I am sending the details separately Yes Criminal records data and your rights Citizens Advice - Hart collects your criminal convictions information to assess your suitability for a role. As stated in the criminal records and convictions policy for applicants we may also need to share the information on this form and attached document (if you have included further detail), with ADS Insurance Broker (and subsequently the insurer) if additional cover is required. We process this data on the basis of substantial public interest in order to safeguard our clients against harm. You have legal rights over your data, including access to it, and the right to ask that it is corrected, restricted or deleted. If you have any questions about the use of your data, please contact Citizens Advice – Hart, Chief Officer Sam Mabbott (ceo@citizensadvicehart.org.uk) If you are recruited for a role, we will keep the self-disclosure form for 6 months from the date of receipt. We will keep the risk assessment, and a record of the decision for 6 years following the end of volunteering. If you are not recruited, we will keep the self-disclosure form for 6 months from the date of this decision. We will keep the risk assessment and record of the decision for 1 year. If you are human, leave this field blank. Declaration and Submission
