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NEW YORK STATE DIVISION OF CRIMINAL JUSTICE SERVICES (County of Fulton)

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BROWSE COUNTY OF FULTON (NY) FORMS

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NEW YORK STATE DIVISION OF CRIMINAL JUSTICE SERVICES
Office of Criminal Justice Operations
Volunteer Firefighter Inquiry Form
INSTRUCTIONS: This form is to be used only by a Sheriff’s Office (or OFPC, where
applicable) when performing searches authorized under NY Executive Law §837-o in
connection with individuals seeking membership in a Volunteer Fire Department.
This form must be U.S. mailed, faxed or hand delivered between agencies. E-mail
transmission is not permissible.
Shaded boxes are required data elements.
A. DATE:
B. REQUESTING VOLUNTEER FIRE DEPARTMENT
DEPARTMENT NAME:
FIRE CHIEF NAME: SIGNATURE:
ADDRESS:
TELEPHONE NUMBER: FAX NUMBER:
1. NAME (LAST, FIRST, MIDDLE)
2. ADDRESS (Street, City, Zip Code)
3. ALIAS AND/OR MAIDEN NAME 4. SEX
M F
5. RACIAL APPEARANCE
White Black Indian Asian Unknown Other
6. ETHNICITY
Hispanic Not Hispanic Unknown
7. HEIGHT
Ft. In.
8. DATE OF BIRTH
Month Day Year
9. PLACE OF BIRTH
10. SOCIAL SECURITY NO.
RESULTS OF INQUIRY
INVESTIGATING OFFICER: _______________________________________________________ DATE ___________________
(PRINT NAME/TITLE)
INVESTIGATING OFFICER SIGNATURE ______________________________________________________________________
NO RECORD OF AN ARSON CONVICTION OR A CONVICTION REQUIRING REGISTRATION AS A SEX OFFENDER
CONVICTED OF ARSON; NO RECORD OF A CONVICTION REQUIRING REGISTRATION AS A SEX OFFENDER
CONVICTED OF A CRIME REQUIRING REGISTRATION AS A SEX OFFENDER; NO RECORD OF AN ARSON CONVICTION
CONVICTED OF ARSON AND CONVICTED OF A CRIME REQUIRING REGISTRATION AS A SEX OFFENDER
DCJS-VFF (12/14)
Non-Fingerprint Background Checks – Volunteer Firefighters
Effective December 2, 2014, Executive Law §837-o requires prospective volunteer
firefighters, and current volunteers seeking membership in another fire company, to undergo
non-fingerprint criminal history background checks, for arson convictions and convictions
which require registration as a sex offender only, against the State’s criminal history files
maintained by the Division of Criminal Justice Services (DCJS). The law prohibits a fee from
being charged in connection with these background checks. The law also specifies that these
checks will be conducted by sheriffs' offices unless a county legislature enacts a local law
prohibiting its county sheriff from having such responsibility. In such a case, the NYS Division
of Homeland Security and Emergency Services, Office of Fire Prevention and Control (OFPC), is
authorized to perform the background checks for the affected volunteer fire companies.
DCJS supplies the DCJS-VFF Volunteer Firefighter Inquiry Form to each Sheriff’s
Office in the State and to OFPC. Sheriffs’ offices and OFPC shall distribute the form to
volunteer fire companies seeking to perform arson and registerable sex offense background
checks on prospective volunteers and fire company transferees. Fire company officials should
complete sections A and B and fields 1 through 10 of the DCJS –VFF Volunteer Firefighter
Inquiry Form. Fire company officials should use the applicant/transferee driver’s license, and
another form of identification, such as a birth certificate, passport or social security card, when
completing the forms. Completed forms must be returned to the sheriff’s office, or to OFPC
where applicable, via U.S. mail, fax or hand delivery. E-mail transmission is not permissible.
It is not an option to perform the background checks through OFPC in counties where there is no
local law prohibiting the sheriff’s office from conducting the checks.
Upon receiving a completed DCJS-VFF Volunteer Firefighter Inquiry Form, sheriffs’
offices will perform a name search on each applicant/transferee using the Criminal Repository
Search link located under the People tab in the eJusticeNY Integrated Justice Portal using the
VFF Reason Code. If a name search candidate is returned as an exact match to the input data, the
sheriff will use the Criminal Repository Inquiry link to obtain a rapsheet from DCJS on the
candidate. The rapsheet will then be examined by the sheriff’s office to determine the presence
of an arson and/or registerable sex offense conviction. Not all sex offense convictions require
registration as a sex offender. If there is any question regarding whether the applicant is a
registered sex offender, the sheriff should search the Sex Offender Registry using the Full
Registry Search link also located under the People tab in the eJusticeNY Integrated Justice
Portal. The appropriate box should be checked on the bottom portion of the DCJS-VFF
Volunteer Firefighter Inquiry Form, and the form returned to the submitting fire company via
U.S. mail, fax or hand delivery only. In cases where the rapsheet shows an arrest for arson and/or
registerable sex offense, but does not reflect a final disposition for the arrest, the sheriff’s office
should contact the DCJS Office of Criminal Justice Operations at (518) 457-8547 for assistance
in obtaining the final disposition. If an arson and/or registerable sex offense case is pending
adjudication, the requesting fire company should be informed that a decision regarding the
applicant/transferee must be delayed. Criminal history records (i.e., rapsheets) are not to be
provided to fire companies under any circumstance.
In cases where a background check results in the discovery of an arson and/or registerable
sex offense conviction against an applicant/transferee and the individual disputes the conviction,
the fire company official should immediately refer the individual to DCJS for a personal record
review. If the personal record review results in the determination that the individual is free of an
arson conviction and/or registerable sex offense conviction, a subsequent notification will be sent
to the sheriff’s office which will then forward the appropriate notification to the fire company. It
should be noted that while an applicant/transferee who has been convicted of arson is not eligible
to be elected or appointed as a volunteer member of a fire company, a registered sex offender is
not automatically disqualified from membership. If the background check results in the
discovery that the applicant/transferee is a registered sex offender, the fire company must make a
determination of eligibility in accordance with the criteria established in Correction Law §§752
and 753. The fire company should be directed to contact the Sex Offender Registry at 1-800-
262-3257 to obtain more information about the conviction.
(12/2014)
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NEW YORK STATE DIVISION OF CRIMINAL JUSTICE SERVICES (County of Fulton)

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Completed 6 August 2020

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