The Virginia W 2 form is an application used to request an exemption from the state's compulsory minimum training standards for certain criminal justice positions. This form must be submitted within 30 days of employment to the Virginia Department of Criminal Justice Services. Completing this application accurately is essential for ensuring compliance and securing the necessary exemptions.
The Virginia W-2 form is a crucial document for individuals seeking exemption from the Commonwealth's compulsory minimum training standards in various law enforcement roles. This form, officially titled the Application for Exemption from Virginia Compulsory Minimum Training Standards, is submitted to the Virginia Department of Criminal Justice Services within 30 days of employment. It requires essential information such as the applicant's name, social security number, employment date, and the specific type of exemption being requested—whether for law enforcement officers, court security personnel, corrections officers, dispatchers, or jailors. Additionally, the form includes sections for detailing previous employment history in criminal justice, listing completed training courses, and certifying the accuracy of the information provided. Each applicant must ensure that both they and their employing agency complete the necessary parts of the form to facilitate the review process. Furthermore, the Virginia Department of Criminal Justice Services will evaluate the application, indicating approval or disapproval based on compliance with established standards. This process not only helps maintain the integrity of law enforcement training but also ensures that those serving in critical public safety roles meet the required qualifications.
Commonwealth of Virginia
Virginia Department of Criminal Justice Services
Application for Exemption from Virginia Compulsory
Minimum Training Standards (Form W-2)
Section 9.1-116, Code of Virginia (1950), as amended
Submit within 30 days of employment to:
Department of Criminal Justice Services, 1100 Bank Street, 12th Floor, Richmond, VA 23219
NOTE: Employing Agency and Applicants must complete Parts A, B, D, E, F on both sides of this application
A. IDENTIFICATION
Applicant’s Name: (Last, First, Middle Initial)
Social Security Number:
─
Title or Rank:
Date of Birth:
Employment Date:
/
Employing Department:
B. TYPE OF EXEMPTION (Please check one)
Law Enforcement Officer
Court Security/Process Server
Corrections Officer, Department of Corrections
Dispatcher
Jailor or Custodial Officer
COMPLETE SECTIONS D, E, F ON PAGE 2
C. DCJS ACTION (DCJS Use Only)
1. Approved Upon Conditions:
Exemption approved upon completion of:
a.
Options:
b.
Options to be completed by:
c.
Field training/On-the-job training required:
Yes (form attached)
No
(Refer to DCJS website for current form)
d.
Certification Examination required:
Yes
e.
Notification of compliance submitted to this office by:
(Form 41 Reporting Roster or letter from Academy Director)
2. Exemption Not Approved:
Reason(s):
Date
DCJS Authorized Signature
Title
cc: Employing Agency, Applicant, Field Coordinator, DCJS Records
June 2012
www.dcjs.virginia.gov
Page 1
D. FORMER EMPLOYMENT
List all previous employment as a criminal justice officer/dispatcher starting with the most recent.
EMPLOYER
BEGIN DATE
END DATE
POSITION
E. TRAINING
Please list all criminal justice basic (ENTRY-LEVEL) courses completed
NAME OF BASIC COURSE
COMPLETION DATE
ACADEMY ATTENDED
F. CERTIFICATION
I certify that the preceding statements are true and correct
Signature of Applicant
I certify that the above statements are correct to the best of my knowledge. Based upon a thorough background investigation, I have determined that this individual has demonstrated sensitivity to cultural diversity issues during previous employment. This individual meets the standards set forth in §9.1-116 of the Code of Virginia.
I request an exemption for the compulsory minimum training as designated for the above named employee.
A Form 21 or Form 31, as applicable, has been previously submitted or is attached.
Signature of Agency Administrator
Name of contact person:
E-mail address:
Phone No.
FAX No.
G.VERIFICATION (DCJS Use Only)
Employment and training status verified:
Staff initials and date
Training:
DCJS Records
Out of State:
Name
Logged out and mailed:
Page 2
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