Free Virginia W 2 PDF Form

Free Virginia W 2 PDF Form

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.

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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.

Preview - Virginia W 2 Form

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:

 

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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

No

 

 

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

 

 

 

 

 

Virginia Department of Criminal Justice Services

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

 

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E. TRAINING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please list all criminal justice basic (ENTRY-LEVEL) courses completed

NAME OF BASIC COURSE

 

 

 

COMPLETION DATE

 

ACADEMY ATTENDED

 

 

 

 

 

 

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F. CERTIFICATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I certify that the preceding statements are true and correct

 

 

 

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Date

 

 

 

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.

Yes

No

A Form 21 or Form 31, as applicable, has been previously submitted or is attached.

Yes

No

 

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Date

 

 

 

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:

Staff initials and date

Virginia Department of Criminal Justice Services

 

www.dcjs.virginia.gov

June 2012

 

Page 2

Document Specifics

Fact Name Fact Description
Purpose The Virginia W-2 form is used to apply for an exemption from the state's compulsory minimum training standards for certain criminal justice positions.
Governing Law This form is governed by Section 9.1-116 of the Code of Virginia (1950), as amended.
Submission Deadline Applicants must submit the form within 30 days of their employment start date.
Submitting Agency Forms should be submitted to the Department of Criminal Justice Services located at 1100 Bank Street, 12th Floor, Richmond, VA 23219.
Applicant Information Applicants must provide their name, Social Security Number, title or rank, date of birth, and employment date on the form.
Exemption Types The form allows applicants to check one of several exemption types, including Law Enforcement Officer, Court Security/Process Server, and others.
DCJS Action The form includes a section for the Department of Criminal Justice Services to indicate whether the exemption is approved or not, along with any conditions.
Former Employment Applicants must list all previous employment as a criminal justice officer or dispatcher, starting with the most recent position.
Certification Requirement Applicants must certify the accuracy of the information provided and confirm compliance with cultural diversity standards during previous employment.
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