Read PSPLA_Certificate_of_Approval_App.pdf text version

Private Security Personnel Licensing Authority

For more information visit www.pspla.govt.nz

ApplicationforaCertificateofApproval

UnderthePrivateSecurityPersonnelandPrivateInvestigatorsAct2010

1

Whatisthisformusedfor?

Usethisformtoapplyforacertificateofapprovaltoenableyoutoworkforalicenceholderintheprivatesecurity industryorasacrowdcontroller(alsoknownasabouncerordoorman).Youcanapplyforacertificateinoneofseven categories.ThesecategoriesarelistedinSection1.

2

Whatdoyouneedtocompleteyourapplication?

Tocompleteyourapplicationyouneedtosend: · Afullycompletedform · Apassportstylephoto(formoreinformationseeoverleaf) · Achequefor$200(or$220ifyouarealsoapplyingforatemporarycertificate)

3

Completingthisform

· PrintclearlyinCAPITALS. · Useablackorbluepentocompletethisform. · Answereveryquestionontheformunlessthe instructions tell you otherwise.

5

How long will it take to hear the outcome of your application?

In normal circumstances it will take a month to hear the outcome of your application. If you have a criminal conviction your application may take longer to process. You can check the progress of your application on www.pspla.govt.nz

4

PaymentInformation

Thefeeforfilinganapplicationfora · Certificateofapprovalis$200 · Temporarycertificateofapprovalisan additional$20 Youcanonlypaybycheque.Makeyourcheque payableto:ThePrivateSecurityPersonnelLicensing Authority.Foraquicker,easier,cheaperwayof applying apply online ­ see www.pspla.govt.nz. Applicationfeesarenon-refundable.

6

Important information

If you: · Providefalseormisleadinginformationtothe LicensingAuthority,youmaybeliableforafineof up to $20,000. · WorkforalicenseeorasaCrowdController withoutholdingaCertificateofApprovalyou couldbefinedupto$20,000. AllpersonalinformationprovidedtothePSPLA willbemanagedinaccordancewiththePrivacyAct 1993.

Page 1

For more information visit www.pspla.govt.nz

PSPLA 12/10 - A

Z

Photograph Requirements

AnyphotographofanindividualsubmittedtotheLicensingAuthorityinnon-electronicformforthepurposeof sections 24, 46, or 111 must: (a) beofgoodquality;and(b)havebeentakennotmorethan6monthsbeforethedateonwhichitis supplied;and (c) beafullfrontviewoftheface,headandshouldersoftheperson,withtheheadfillingmostofthe photograph;and (d) haveaplain,lightcolouredbackground(notwhiteordark)withnobackgroundshadow;and (e) showtheindividualwithoutaheadcovering,hat,headband,bandannaorscarfexceptfor religiousormedicalreasons.Inallcases,facialfeaturesfromthebottomofthechintothetop oftheforeheadandbothedgesofthefacemustbeclearlyshown;and (f) beacolourphotograph;and(g)beagoodlikenessoftheperson;and(h)be45mmhighx35mm wide;and(i)beongoodqualitypaper. Z

Attach photo here 45mmhighx35mmwide

Section 1 - Application Details

What class or classes of work are you applying for: (you may tick Privateinvestigatoremployee Confidentialdocumentdestructionagentemployee Securitytechnicianemployee Personalguardemployee Note:crowdcontrollersandprivateinvestigatorshavespecialresponsibilities.Formoreinformationgotowww.PSPLA.govt.nz If you need to work for a licence holder or as a crowd controller employee whilst your application is being processed, you may be eligible for a temporary certificate of approval. Do you wish to apply for a temporary certificate of approval (Please tick to confirm Yes No ) more than one) Securityconsultantemployee Propertyguardemployee Crowdcontrolleremployee

Please note a temporary certificate of approval is an additional $20.00 (in addition to your application fee). IfyouhavepreviouslyheldalicenceoracertificateofapprovalunderthePrivateInvestigatorsandSecurityGuardsAct 1974orthePrivateSecurityPersonnelandPrivateInvestigatorsAct2010,provideyourlicencenumberorcertificate number here:

Z

Section 2 ­ Personal Details

What is your name? Firstname(s) Middlename(s) Lastname(s) Are you known by, or have you ever been known by another name? (Please tick to confirm Yes Other name 1 Firstname(s) Middlename(s) Lastname(s) No Ifyespleasesupplydetails,ifnoleavethisboxblankandmoveontothenextquestion. )

Page 2

For more information visit www.pspla.govt.nz

PSPLA 12/10 - A

Z

Section 2 ­ Personal Details (contd)

Other name 2 Firstname(s) Middlename(s) Lastname(s) DateofBirth//(day/month/year) What is your gender? (Please tick to confirm Male Female ) )

Are you currently employed? (Please tick to confirm Yes No

Ifyes,pleasesupplyfurtherdetailsbelow,ifnopleasemovetotheresidentialaddressquestion. Whatisyouroccupation? Whoareyouemployedby? Ifyouareemployedbyseveralemployerspleaselisttheirnameshere

What is your residential address? Street Suburb Postcode Country Do you have a different postal address? (Please tick to confirm Yes No Ifyeswhatisyourpostaladdress: Street/POBox Suburb Postcode Country City/town State(ifoutsideofNZ) ) City/town State(ifoutsideofNZ)

Page 3

For more information visit www.pspla.govt.nz

PSPLA 12/10 - A

Z

Section 2 ­ Personal Details (contd)

How can we contact you? Daytimecontactnumber() Mobilenumber Emailaddress

Z

Othercontactnumber() Faxnumber()

Section 3 ­ Photo Identification Details

Photo identification is required to verify your identity when you pick up your Certificate of Approval and ID badge. Please provide details of your Passport, New Zealand Driver's Licence, HANZ 18+ card or New Zealand Firearms Licence below:

Passportnumber Nationality as shown on passport Passportexpirydate//(day/month/year) or NewZealandDriver'sLicencenumber Driver'sLicenceexpirydate//(day/month/year) Driver'sLicenceversionnumber Dateissued//(day/month/year)

or

Otheridentificationtype Otheridentificationnumber

Z

HANZ18+

NZFirearmslicence

Section 4 ­ Disqualification Criteria

You are not eligible to hold a certificate of approval if disqualification criteria apply to you. Section 62 of the Private Security Personnel and Private Investigators Act 2010 lists certain grounds that may disqualify you from being granted a certificate of approval. If you meet any of the grounds of disqualification listed below, you will be able to make a statement about your character, circumstances or background. The Licensing Authority may still grant your application, but only if the Authority is satisfied that you are suitable to work in the class or classes of work to which the application relates. Please note that no refund is payable if your application is unsuccessful. You can find more information at www.PSPLA.govt.nz Please answer each individual question below. (Please tick to confirm ) Yes Yes No No

Haveyoueverbeenconvictedofa`specifiedoffence'asdefinedinsection4oftheCriminalRecords(Clean Slate)Act2004? Inthelast7years,haveyoubeenconvictedbyaNewZealandcourtofanoffenceundertheArmsAct1983?

Page 4

For more information visit www.pspla.govt.nz

PSPLA 12/10 - A

Z

Section 4 ­ Disqualification Criteria (contd)

(Please tick to confirm ) Yes Yes Yes Yes No No No No

Inthelast7years,haveyoubeenconvictedbyaNewZealandcourtofanoffenceundersections216Hto 216JoftheCrimesAct1961? Inthelast7years,haveyoueverbeenconvictedbyaNewZealandcourtofanoffenceundersections10,11, 13,16,19,21,24,47F,or47JoftheFairTradingAct1986? Inthelast7years,haveyoueverbeenconvictedbyaNewZealandcourtofanoffenceundersection8or25 of the Harassment Act 1997? Inthelast7years,haveyoueverbeenconvictedbyaNewZealandcourtofanoffenceundersection6of theMisuseofDrugsAct1975inrelationtoquantitiesdeemedforsupplyofaClassA,BorCcontrolled drugordrugs? Inthelast7years,haveyoueverbeenconvictedbyaNewZealandcourtofanoffenceofdishonesty, asdefinedinsection4ofthePrivateSecurityPersonnelandPrivateInvestigatorsAct2010("offenceof dishonesty")? Inthelast7years,haveyoueverbeenconvictedbyaNewZealandcourtofanoffenceofviolence,as definedinsection4ofthePrivateSecurityPersonnelandPrivateInvestigatorsAct2010("offenceof violence")? Inthelast7years,haveyoueverbeenconvictedbyaNewZealandcourtofanoffenceundersections16,34 or52ofthePrivateInvestigatorsandSecurityGuardsAct1974? Haveyoueverbeendisqualifiedfromdrivingundersection65oftheLandTransportAct1998,oranearlier equivalentprovision? HaveyoueverbeenorderedbyaNewZealandcourttobeimprisonedfollowingconvictionforanoffence andthatconvictionororderhasnotbeenquashedonappeal? Inthelast7years,haveyoueverbeenconvictedbyaNewZealandcourtofanoffenceunderthePrivate SecurityPersonnelandPrivateInvestigatorsAct2010orPrivateInvestigatorsandSecurityGuardsAct 1974forworkingwithoutalicenceorcertificateorapprovaloremployingorengagingapersonwithouta certificateofapproval? Inthelast7years,haveyouhadalicenceorcertificateofapprovalcancelledunderthePrivateSecurity PersonnelandPrivateInvestigatorsAct2010orthePrivateInvestigatorsandSecurityGuardsAct1974? Doyouholdalicenceorcertificateofapprovalthathasbeensuspended? Haveyoueverhadanordermadeinrelationtoyouundersection34(1)(b)oftheCriminalProcedure (MentallyImpairedPersons)Act2003,section118oftheCriminalJusticeAct1985,orsection39Jofthe CriminalJusticeAct1954(beinganorderimposed,insteadofpassingsentence,thatyoubetreatedor caredforinamannerthatyourmentalimpairmentrequires,eitherinyourowninterest,orthesafetyof thepublic,orforthesafetyofthepublic,orforthesafetyorapersonorclassofperson)? Areyoucurrentlysubjecttoacourtorderthatrequiresyoutobedetainedinahospitalbecauseofa mentalcondition?

Yes

No

Yes

No

Yes Yes Yes Yes

No No No No

Yes Yes Yes

No No No

Yes

No

Page 5

For more information visit www.pspla.govt.nz

PSPLA 12/10 - A

Z

Section 4 ­ Disqualification Criteria (contd)

If you have answered yes to a ground for disqualification you can provide further information to support your application (for example, evidence of your character, circumstances, or background).

Ifyouneedextraspacepleaseattachaseparatesheettothisapplication. Haveyoumetanyrequirementsprescribedinregulationsmadeundersection114(h)(i)ofthePrivate SecurityPersonnelandPrivateInvestigatorsAct2010,(whichrelatetothecompetency,knowledge,and skillsrequiredforlicencesandcertificatesofapproval)? [You must provide proof of meeting those requirements with this application.] Yes No

If you have completed any of the training requirements set out in section 114(1)(h) of the Private Security Personnel and Private Investigators Act 2010, please provide details below:

Ifyouneedextraspacepleaseattachaseparatesheettothisapplication.

Z

Section 5 ­ Overseas Mental Health Orders and Convictions

Section 46 of the Private Security Personnel and Private Investigators Act 2010 also requires that you specify if you have had an overseas mental health order or conviction.You may provide further information to support your application (for example, information about your character, circumstances, or background) if you have specified a conviction or order as follows: (Please tick to confirm ) Yes No

HaveyoueverhadanorderimposedinrelationtoyoubyanycourtortribunaloutsideofNewZealand, insteadofpassingsentence,thatyoubetreatedorcaredforinrelationtoyourmentalimpairment? HaveyoueverbeenconvictedofanoffenceoutsideofNewZealand? Please provide further information below:

Yes

No

Ifyouneedextraspacepleaseattachaseparatesheettothisapplication.

Page 6 For more information visit www.pspla.govt.nz PSPLA 12/10 - A

Z

Section 6 ­ Certificate and Badge Collection

WhichbranchofNZPostwouldyouprefertopickupyourcertificateofapprovalandIDbadgefrom(shouldyourapplicationbe successful?)­alistofbranchescanbefoundatwww.pspla.govt.nz Location

Z

Section 7 ­ Consent and Certification

IconsenttotheMinistryofJusticeundertakingacriminalhistorycheckusingtheinformationcontainedinmyapplication.Icertify thattheaboveparticularsaretrueandcorrect. Name Signature

Z

Date//(day/month/year)

Section 8 ­ Checklist

Before you submit this form please check that: (Please tick to confirm Youhaveansweredeveryapplicablequestion; Youhaveattachedyourphotograph; Youhavesignedanddatedthisform;and Youhaveincludedachequetotallingtheamountoftheapplication. )

Please mail this completed form with photograph and cheque to:

PrivateSecurityPersonnelLicensingAuthority SX10042 Wellington

Page 7

For more information visit www.pspla.govt.nz

PSPLA 12/10 - A

Z

Legislative Extract - Definitions of Certificate of Approval classes of business

Meaning of private investigator employee In this Act, private investigator employeemeansanindividualwhointhecourseofhisorheremployment,orengagementasa contractor,byaprivateinvestigatorseeks,orobtainsforanypersonorsuppliestoanyperson,anyinformationspecifiedinsection5(2). Meaning of security technician employee In this Act, security technician employeemeansanindividualwhointhecourseofhisorheremployment,orengagementas acontractor,byasecuritytechnician--(a)installsorrepairson,orremovesfrom,anypartofanypremisesthatarenotownedor occupiedbythesecuritytechnician,thesecuritytechnician'sfirm,oranyofthesecuritytechnician'spartners--(i)aburglaralarmor similarwarningdeviceintendedtoimmediatelyalertapersonorpersonstothepresenceofapersonorpersonsinaparticularplace; or(ii)alockingdeviceforasafeorastrongroom;or(b)installs,operates,causestobeoperated,orrepairs,onorin,orremovesfrom, anypremisesorotherplacenotownedoroccupiedbythesecuritytechnician,thesecuritytechnician'sfirm,oranyofthesecurity technician'spartnersanycameraorsimilardeviceforthepurposeofdetectingthecommissionofanyoffencebyanyperson. Meaning of security consultant employee In this Act, security consultant employeemeansanindividualwhointhecourseofhisorheremployment,orengagementasa contractor,byasecurityconsultant--(a)entersanypremisesthatarenotownedoroccupiedbythesecurityconsultant,thesecurity consultant'sfirm,oranyofthesecurityconsultant'spartnersforthepurposeofsellingorattemptingtosellanydeviceofthekind referredtoinsection6(1)(a)or(b);or(b)entersanypremisesthatarenotownedoroccupiedbythesecurityconsultant,thesecurity consultant'sfirm,oranyofthesecurityconsultant'spartnersforthepurposeofadvisingtheowneroroccupierofthepremisesonthe desirabilityofhavinginstalledonthepremisesany,oranyfurther,suchdevice;or(c)entersanypremisesthatarenotownedoroccupied bythesecurityconsultant,thesecurityconsultant'sfirm,oranyofthesecurityconsultant'spartnersforthepurposeofadvisingthe owneroroccupierofthepremisesonthedesirabilityofhavingguardedthepremisesoranyotherpropertythatmayfromtimetotime beonthepremisesordispatchedfromthepremises.

Legislative extract - Definitions of Certificate of Approval classes of business (contd)

Meaning of confidential document destruction agent employee In this Act, confidential document destruction agent employeemeansanindividualwhointhecourseofhisorheremployment, orengagementasacontractor,byaconfidentialdocumentdestructionagent--(a)collects,fordestruction,documentsidentifiedas beingofaconfidentialnature;and(b)destroysthosedocuments. Meaning of property guard employee In this Act, property guard employeemeansanindividualwhointhecourseofhisorheremployment,orengagementasa contractor,byapropertyguard--(a)guards,elsewherethanonpremisesownedoroccupiedbythepropertyguard,theproperty guard'sfirm,oranyofthepropertyguard'spartners,anyrealorpersonalpropertybelongingtoanotherperson;or(b)monitorsinreal time,elsewherethanonpremisesownedoroccupiedbythepropertyguard,thepropertyguard'sfirm,oranyofthepropertyguard's partners,anyofthefollowing:(i)aburglaralarmorsimilarwarningdeviceintendedtoimmediatelyalertapersonorpersonstothe presenceofapersonorpersonsinaparticularplace:(ii)acameraorsimilardevice;or(c)respondstoanydeviceinparagraph(b)(i)or (ii)thathasbeenactivatedandthatisonanypartofanypremisesthatarenotownedoroccupiedbythepropertyguard,theproperty guard'sfirm,oranyofthepropertyguard'spartners. Meaning of personal guard employee In this Act, personal guard employeemeansanindividualwhointhecourseofhisorheremployment,orengagementasacontractor, byapersonalguard--(a)guardsaspecificpersonorpersons;or(b)guardsaspecificpersonorpersonsandkeepsorderatanyplace (notbeingpremisesoraconveyancelicensedundertheSaleofLiquorAct1989)wherethepersonorpersonsbeingguardedmaybe. Meaning of crowd controller employee (1)InthisAct,crowd controller employeemeansanindividualwhointhecourseofhisorheremployment,orengagementasa contractor,byacrowdcontrollerorotherperson--(a)screensentrytoaplace(otherthansimplyensuringthatadmissionhasbeen paidorthatthoseenteringhaveappropriateinvitationsorpasses):(b)keepsorderinaplace(morethanmerelybeingexpectedtodraw theattentionofotherstobehaviourthatisinappropriateorthreatenstobecomeinappropriate):(c)removesanypersonfromaplace. (2)Apersonisnotacrowdcontrolleremployeeif--(a)heorsheisnotemployedorengagedprimarilytodoworkofakindspecified insubsection(1)(a),(b),or(c),butperformsthatworkincidentallytotheprincipalworkheorsheperforms;or(b)heorshedoesthe workspecifiedinsection18(b)andnootherworkofakindspecifiedinsubsection(1)(a),(b),or(c).

Page 8

For more information visit www.pspla.govt.nz

PSPLA 12/10 - A

Information

8 pages

Find more like this

Report File (DMCA)

Our content is added by our users. We aim to remove reported files within 1 working day. Please use this link to notify us:

Report this file as copyright or inappropriate

679444