Fill in a Valid New Jersey Sp 171 Template
The New Jersey SP 171 form is a crucial document for individuals seeking to obtain a private detective license in the state. This application is managed by the New Jersey Division of State Police and requires comprehensive personal and professional information from the applicant. Key sections of the form include the applicant's name, home address, and contact details, as well as information regarding the agency or trade name under which the applicant intends to operate. It is essential for all license qualifiers, corporate officers, partners, or LLC members to complete the application personally, ensuring accuracy and completeness to avoid potential denial. The form also mandates the submission of a recent photograph and requests detailed background information, including any prior applications for a private detective license, criminal history, and employment history in law enforcement or investigative roles. Additionally, applicants must provide references who can vouch for their character and competency, further emphasizing the importance of integrity in this profession. The form highlights the necessity of obtaining authorization for any trade names used, ensuring that the name does not mislead the public. Understanding the requirements and implications of the SP 171 form is vital for those looking to navigate the licensing process successfully.
Example - New Jersey Sp 171 Form
STATE OF NEW JERSEY
DIVISION OF STATE POLICE
APPLICATION FOR PRIVATE DETECTIVE LICENSE
CASE FILE NUMBER
NAME (Print — Last) |
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Home Address |
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(Street or R.D. Number) |
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COUNTY |
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ZIP CODE |
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NAME OF AGENCY and/or TRADE NAME |
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PRESENT OR |
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(Street or R.D. Number) |
(City) |
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PROPOSED |
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ADDRESS OF AGENCY |
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COUNTY |
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STATE |
ZIP CODE |
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MAILING |
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(Street or R.D. Number) |
(City) |
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ADDRESS |
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IF DIFFERENT |
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COUNTY |
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STATE |
ZIP CODE |
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HOME PHONE NUMBER
(Area Code/Number) |
AGENCY PHONE NUMBER |
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(Area Code/Number) |
MAIL ALL DOCUMENTS TO:
NEW JERSEY STATE POLICE
PRIVATE DETECTIVE UNIT
P.O. BOX 7068
WEST TRENTON, NEW JERSEY 08628
All license Qualifiers, Corporate Officers, Partners or LLC Members shall complete an application.
Provide all information requested within this application and any other attached forms.
The application shall be completed personally by the applicant.
Any omission or misstatement of fact is grounds for DENIAL - NJAC
Any person who shall knowingly state any fact falsely shall be guilty or a misdemeanor - NJS
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CHECK THE APPROPRIATE BOX FOR THE LICENSE TYPE OR POSITION
Individual License Qualifiers* |
Corporate License Qualifiers* |
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Corporate License Officer |
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LLC License Qualifiers* |
Partnership License Qualifiers* |
LLC License Member |
Partnership License |
*The Qualifier is that person who has 5 years' experience as an investigator or a police officer.
All Corporate, LLC, and Partnership applications shall be submitted together as one entity.
List the name and address of all Corporate Officers, LLC members, or Partners
Name
Address
NAME OR TRADE NAME
New Jersey Administration Code
No licensee shall conduct business under a name or trade name unless authorization has been obtained from the Superintendent of the New Jersey State Police. The Superintendent shall not authorize the use of a trade name which, in his opinion, is so similar to that of a public officer or agency, or that used by another licensee, that the public may be confused or misled thereby. The authorization shall require the filling of a trade name with the County Clerk for an Individual or Partnership license or with the Department of Treasury, Commercial Recording and Business Services for a Corporation or LLC license.
Use of a name different from an individual's name shall require filling with the County Clerk
Out of State Corporations or LLC's shall file with the Department of Treasury
SELECT TWO NAMES
1._______________________________________________________________________________________
2._______________________________________________________________________________________
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PHOTOGRAPH
ATTACH CURRENT
FULL FACE PHOTO
No exposure below shoulders
NAME |
Last |
First |
MI |
SOCIAL SECURITY NUMBER
DATE OF BIRTH |
HEIGHT |
WEIGHT |
EYE COLOR |
HAIR COLOR |
RACE |
Have you ever held or applied for a Private Detective License in this or any other State? If Yes, state full details.
YES NO
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Have you ever been DENIED, or had a Private Detective License REVOKED or SUSPENDED in this or any other State? If Yes, state full details.
YES NO
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Have you ever attended, been treated or observed by any doctor or psychiatrist, or at any hospital or mental institution on an impatient or
YES NO
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Have you been CONVICTED of any Disorderly Persons Offenses or any Criminal Laws of this State or any other jurisdiction? If Yes, state full details. (Offense, Date, Location)
YES NO
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
UTILIZE THE CONTINUATION PAGE FOR ADDITIONAL DETAILS TO ANY QUESTION
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EMPLOYMENT
List All Police or Investigative Employment |
(Past & Present) |
TO BE COMPLETED BY APPLICANT'S EMPLOYER
EMPLOYING AGENCY
ADDRESS
DATE EMPLOYED FROM - Month/Year |
TO - Month/Year |
SUPERVISOR NAME/TITLE
SUPERVISOR SIGNATURE
APPLICANT - POSITION/TITLE
REASON FOR TERMINATION OF EMPLOYMENT
EXPLANATION OF APPLICANT'S DUTIES/GENERAL COMMENTS
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TO BE COMPLETED BY APPLICANT'S EMPLOYER
EMPLOYING AGENCY
ADDRESS
DATE EMPLOYED FROM - Month/Year |
TO - Month/Year |
SUPERVISOR NAME/TITLE
SUPERVISOR SIGNATURE
APPLICANT - POSITION/TITLE
REASON FOR TERMINATION OF EMPLOYMENT
EXPLANATION OF APPLICANT'S DUTIES/GENERAL COMMENTS
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UTILIZE THE CONTINUATION PAGE FOR ADDITIONAL SPACE
* Employer's letterhead stationary, providing the same information, may substitute for this form*
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REFERENCES
The applicant shall insure that five reputable citizens, unrelated to the applicant and over the age of 21, complete the following information and provide a signature attesting to the approval of the applicant.
A reference shall only complete and sign if offering approval of the applicant's character and competency to be licensed as a New Jersey Private Detective.
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PRINT NAME |
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HOME PHONE |
WORK PHONE |
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SIGNATURE |
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PRINT NAME |
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HOME PHONE |
WORK PHONE |
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SIGNATURE |
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3. |
PRINT NAME |
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WORK PHONE |
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SIGNATURE |
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PRINT NAME |
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WORK PHONE |
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SIGNATURE |
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5. |
PRINT NAME |
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HOME PHONE |
WORK PHONE |
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SIGNATURE |
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5
AUTHORIZATION FOR RELEASE OF INFORMATION
TO WHOM IT MAY CONCERN:
I, ____________________________________, AM HAVING A CONFIDENTIAL BACKGROUND
PRINT NAME
INVESTIGATION CONDUCTED ON ME BY THE NEW JERSEY STATE POLICE.
THEREFORE, I AUTHORIZE A REVIEW, FULL DISCLOSURE, AND RELEASE OF ALL RECORDS OR INFORMATION, OR ANY PART THEREOF, CONCERNING MYSELF TO ANY SWORN MEMBER OF THE NEW JERSEY STATE POLICE, WHETHER THE SAID RECORDS OR INFORMATION ARE PUBLIC OR PRIVATE, AND INCLUSIVE OF RECORDS OR INFORMATION CONSIDERED PRIVILEGED OR CONFIDENTIAL IN NATURE.
THE RELEASE AUTHORIZATION IS INTENDED TO PROVIDE A RELEASE OF ANY INFORMATION THAT CAN BE UTILIZED AS INVESTIGATIVE RESOURCE MATERIAL DURING THE BACKGROUND INVESTIGATION FOR A NEW JERSEY PRIVATE DETECTIVE LICENSE, AND DURING AN INDIVIDUAL'S ENTIRE LICENSE PERIOD. THE RELEASE WILL REMAIN IN EFFECT DURING THE INITIAL LICENSE PERIOD AND SUBSEQUENT LICENSE RENEWAL PERIODS.
A PHOTOSTATIC COPY OF THIS AUTHORIZATION WILL BE CONSIDERED AS EFFECTIVE AND VALID AS THE ORIGINAL.
SIGNATURE MUST BE NOTARIZED
I,________________________________________________________ AFFIRM THAT I AM THE ABOVE
PRINT NAME
NAMED PERSON MAKING APPLICATION FOR A NEW JERSEY PRIVATE DETECTIVE LICENSE. I READ AND ANSWERED EACH QUESTION WITHIN THE APPLICATION COMPLETELY AND TRUTHFULLY.
_________________________________________________
APPLICANT SIGNATURE |
DATE |
Sworn to before me this
___________________________ day of ________________________, _________
YEAR
__________________________________________________
Notary Public
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CONTINUATION PAGE
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STATE POLICE USE ONLY |
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RECORD SEARCH REPORT |
PRIVATE DETECTIVE UNIT |
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PROMIS GAVEL |
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AUTOMATED COURT SYSTEM |
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PRIVATE DETECTIVE UNIT |
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AFFIRM |
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N.C.I.C./S.C.I.C |
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MOTOR VEHICLE |
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FEDERAL PRINT |
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STATE PRINT |
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CREDIT |
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Form Specs
| Fact Name | Details |
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| Form Title | Application for Private Detective License |
| Governing Law | New Jersey Administrative Code (NJAC) 13:55-1.11 |
| Application Requirement | All license qualifiers, corporate officers, partners, or LLC members must complete the application. |
| Omission Consequence | Any omission or misstatement may lead to denial of the application. |
| False Statements | Knowingly stating false facts is a misdemeanor under NJS 45:19-11. |
| License Types | Includes individual, corporate, partnership, and LLC license qualifiers. |
| Trade Name Authorization | Licensees must obtain authorization from the Superintendent to use a trade name. |
| Photo Requirement | A current full-face photograph must be attached to the application. |
| References Needed | Five reputable citizens, unrelated to the applicant, must provide references. |
| Submission Address | Documents must be mailed to the New Jersey State Police Private Detective Unit. |
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