Get the free Self Disclosure Statement - grcity

This document is used by the City of Grand Rapids to gather self-disclosure information from applicants regarding any criminal convictions or driving citations that could affect their appointment.

How to fill out self disclosure statement

How to fill out Self Disclosure Statement

1. Obtain the Self Disclosure Statement form from the relevant authority or website.
2. Read the instructions carefully to understand the information required.
3. Fill in your personal information accurately, including name, contact details, and date of birth.
4. Disclose any relevant past legal issues, such as convictions or pending charges, as per the guidelines.
5. Include any professional qualifications or licenses that may be applicable.
6. Review your answers for completeness and accuracy.
7. Sign and date the Self Disclosure Statement to certify your disclosures.
8. Submit the completed form to the designated office or email address as instructed.

Who needs Self Disclosure Statement?

1. Individuals applying for jobs in sensitive industries, such as finance, healthcare, or education.
2. Professionals seeking licenses or certifications that require background checks.
3. Organizations requiring volunteer background checks, such as schools or non-profits.
4. Anyone applying for positions involving governance, security, or oversight responsibilities.

People Also Ask about

What is an example of a self-disclosure statement?

It is important, however, that I disclose my unspent conviction to you. Just over two years ago, I received an eight month prison sentence for an overpayment of benefits. At the time of my conviction, I was going through a very difficult divorce from my husband which meant I had to leave my job and move to a new area.

What is a good example of self-disclosure?

Factual disclosures reveal facts and information about the self (e.g., "I am divorced from my husband.") while emotional disclosures reveal a person's feelings, thoughts and judgments (e.g., "My divorce was so painful it has made it difficult for me to trust a romantic partner again").

What is a statement of self-disclosure?

Self-disclosure is defined as verbal communication about the self to another individual or group of individuals, including thoughts, opinions, feelings, beliefs, demographics, and experiences (Derlega, Metts, Petronio, & Margulis, 1993).

What is a disclosure statement example?

I hereby certify that, to the best of my knowledge, neither I (including any member of my immediate family) nor any individual or entity with whom or wijt h which I have a significant working relationship have (has) received something of value from a commercial party related directly or indirectly to the subject of

What is an example of a disclosure statement?

I hereby certify that, to the best of my knowledge, neither I (including any member of my immediate family) nor any individual or entity with whom or wijt h which I have a significant working relationship have (has) received something of value from a commercial party related directly or indirectly to the subject of

How to write self-disclosure?

A self-disclosure statement provides an opportunity to explain your criminal record in a structured and positive way. It allows you to present your past with honesty and humility while focusing on the progress you have made. A well-prepared statement can help you disclose with confidence in applications or interviews.

For pdfFiller’s FAQs

What is Self Disclosure Statement?

A Self Disclosure Statement is a document that individuals or entities must complete to reveal information regarding their compliance with certain regulations, particularly in healthcare or other regulated industries.

Who is required to file Self Disclosure Statement?

Individuals or organizations that have information to disclose regarding potential violations of laws or regulations are typically required to file a Self Disclosure Statement.

How to fill out Self Disclosure Statement?

To fill out a Self Disclosure Statement, you must provide accurate and detailed information regarding the violations or concerns, including any relevant dates, names, and descriptions of the events.

What is the purpose of Self Disclosure Statement?

The purpose of a Self Disclosure Statement is to promote transparency and accountability by allowing individuals or organizations to voluntarily report compliance issues and seek to rectify them, often to avoid penalties.

What information must be reported on Self Disclosure Statement?

The information that must be reported generally includes details of the violation, the parties involved, dates of occurrence, corrective actions taken, and any other relevant facts or context surrounding the issue.