Press Pass Application Form

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LOS SANTOS COUNTY SHERIFF'S DEPARTMENT
PRESS PASS APPLICATION



Sheriff's Information Bureau
300 Innocence Blvd., Los Santos, SA 90220
[email protected]


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Type (select one)
  • New Application / Renew Application




CONDITIONS THAT YOU ARE AGREEING TO:
(4) This credential will be used only by the person to whom issued, and
only in the line of duty. If used otherwise, it may be revoked.
(5) This credential is the property of the Sheriff and is subject to
revocation. This credential must be surrendered upon demand or
upon any change of employment.
(1) To assume all risks
(2) To abide by directions of officers where this credential is presented
(3) Possession of this card will not entitle entry to restricted areas if
such entry interferes with the duties of fire and/or police personnel



*Lying on application WILL result in denial of press pass.
ALL FIELDS ARE MANDATORY


SECTION 1: PERSONAL INFORMATION

1. YOUR LEGAL NAME

Title: MR. / MS. / MRS.
First: ANSWER HERE
Middle: ANSWER HERE
Last: ANSWER HERE


2. BIRTHDATE (DD/MMM/YYYY)

ANSWER HERE


3. BIRTH PLACE (CITY / COUNTY / STATE / COUNTRY)

ANSWER HERE


4. CITIZENSHIP:

[—] U.S. Citizen
[—] Resident Alien who is eligible and applied for U.S. Citizenship
[—] Other


5. ADDRESS WHERE YOU LIVE (XX Street Name, Area, City ZIPCODE, State)

ANSWER HERE

SECTION 2: AGENCY INFORMATION

1. AGENCY NAME:

ANSWER HERE


2. POSITION:

ANSWER HERE


3. BUSINESS ADDRESS: (XX Street Name, Area, City ZIPCODE, State)

ANSWER HERE


4. DUTIES SUMMARY:

ANSWER HERE



Applicant's Signature:
Sign Here
Date:
DD/MMM/YYYY
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Sheriff's Information Bureau
Sheriff Roderick Hayward
Bureau Administration Lieutenant Vacant

Re: Press Pass Application Form

2
(( Applicants are expected to create a new thread here. The Subject of the thread should be:

Code: Select all

[PRESS PASS] Firstname Lastname
))

Code: Select all

[aligntable=right,150,0,0,0,0,transparent][img]https://i.imgur.com/YltBOD6.png?1[/img][/aligntable] [break] 
[justify][size=130][b]LOS SANTOS COUNTY SHERIFF'S DEPARTMENT
PRESS PASS APPLICATION[/b][/size][break]

[size=90]Sheriff's Information Bureau
300 Innocence Blvd., Los Santos, SA 90220
[email protected][/size][/justify]

[break][/break]

[aligntable=right,150,0,0,0,0,transparent]
[img]https://agcnwo.com/wp-content/uploads/2020/09/avatar-placeholder.png[/img]
[/aligntable]

[size=150][b]Type (select one)[/b] [/size][list=none]
                  [size=120]   New Application / Renew Application    [/size]
[/list]

[break][break][break]

[center][b][u][size=115]CONDITIONS THAT YOU ARE AGREEING TO:[/size][/u][/b][/center]

[aligntable=right,0,0,0,0,0,transparent][size=92][b](4) This credential will be used only by the person to whom issued, and
only in the line of duty. If used otherwise, it may be revoked.
(5) This credential is the property of the Sheriff and is subject to
revocation. This credential must be surrendered upon demand or
upon any change of employment.[/b][/size]
[/aligntable][size=92][b](1) To assume all risks
(2) To abide by directions of officers where this credential is presented
(3) Possession of this card will not entitle entry to restricted areas if
such entry interferes with the duties of fire and/or police personnel[/b][/size]



[center][i][b][u]*Lying on application WILL result in denial of press pass.[/u][/b][/i]
[size=120][b]ALL FIELDS ARE MANDATORY[/b][/size][/center]

[break][/break]
[font=Arial][altdivbox2=#303030][size=100][color=white][b]SECTION 1: PERSONAL INFORMATION[/b][/color][/size][/altdivbox2][indent]

[b]1.[/b] YOUR LEGAL NAME [indent]

Title: MR. / MS. / MRS.
First: ANSWER HERE
Middle: ANSWER HERE
Last: ANSWER HERE
[/indent]

[b]2.[/b] BIRTHDATE (DD/MMM/YYYY) [indent]

ANSWER HERE
[/indent]

[b]3.[/b] BIRTH PLACE (CITY / COUNTY / STATE / COUNTRY) [indent]

ANSWER HERE
[/indent]

[b]4.[/b] CITIZENSHIP:  [indent]

[—] U.S. Citizen
[—] Resident Alien who is eligible and applied for U.S. Citizenship
[—] Other
[/indent]

[b]5.[/b] ADDRESS WHERE YOU LIVE (XX Street Name, Area, City ZIPCODE, State) [indent]

ANSWER HERE
[/indent][/indent]

[altdivbox2=#303030][size=100][color=white][b]SECTION 2: AGENCY INFORMATION[/b][/color][/size][/altdivbox2][indent]

[b]1.[/b] AGENCY NAME: [indent]

ANSWER HERE
[/indent]

[b]2.[/b] POSITION: [indent]

ANSWER HERE
[/indent]

[b]3.[/b] BUSINESS ADDRESS: (XX Street Name, Area, City ZIPCODE, State) [indent]

ANSWER HERE
[/indent]

[b]4.[/b] DUTIES SUMMARY: [indent]

ANSWER HERE
[/indent][/indent][/font]



[aligntable=left,0,15,0,0,0,transparent]
[b]Applicant's Signature: [/b]
Sign Here
[/aligntable]
[right][b]Date:[/b] 
DD/MMM/YYYY[/right]
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Sheriff's Information Bureau
Sheriff Roderick Hayward
Bureau Administration Lieutenant Vacant