Instructions to the Applicant

The information you provide in this Preliminary Background Application will be used in the background investigation to assist in determining your suitability for the position of City of Los Santos Police Officer, in accordance with San Andreas POST Commission Regulation 1953.

• • It is your responsibility to complete this form and provide all required information.
  
  • This document must be filled out electronically and printed.
  
  • You must respond to all items and questions. If a question does not apply to you, write “DNA” (does not apply) in the space provided.
  
  • Send the completed form to your background investigator or the department. Do NOT send the form to POST.
  
  • (( Your application must be titled "Firstname Lastname. ))
  
  • (( Your answers should only replace the fields that say "Answer." It should not extend outside the color code box. ))
  
  • (( Do not edit the application format in any way. You may add additional fields to any area or questions or replace hyperlinks with DNA. ))
  
  • (( You may be non-select if your application is put on "Pending" status more than twice for formatting issues or missing questions. This is also the case in character. ))
  
  • (( Upon completion of this application, your character will undergo a 'psychological evaluation'. This is entirely an NPC process. It is your responsibility to inform the Personnel and Training Division if your psychological evaluation fails or shows any concerns. ))

Disqualification

There are very few automatic bases for rejection. Even issues of prior misconduct, such as prior illegal drug use, driving under the influence, theft, or even arrest or conviction are usually not, in and of themselves, automatically disqualifying. However, deliberate misstatements or omissions can and often will result in your application being rejected, regardless of the nature or reason for the misstatements/omissions. In fact, the number one reason individuals “fail” background investigations is because they deliberately withhold or misrepresent job-relevant information from their prospective employer.

BOTTOM LINE: You are responsible for providing complete, accurate, and truthful responses.


Page 1 of 6

1. Your Full Name:

• Last: Velazquez
  First: Samuel
  Middle: DNA

2. Birthdate:

• 13/06/1998

3. Birthplace:

• Los Santos, Los Santos County, San Andreas, United States

4. Sex:

• [X] Male
  [—] Female

5. Race/Ethnic Category:

• [—] Black
  [X] Hispanic
  [—] Asian
  [—] Caucasian
  [—] Pacific Islander
  [—] American Indian or Alaskan Native
  [—] Filipino
  [—] Two or more races

6. Height:

• 6 ft 1 in

7. Weight:

• 192 lbs

8. Address:

• 1193, Bay City Ave

9. Contact Number:

• 5726279

10. Are you a U.S. citizen?

• [X] Yes
  [—] No
  
  • 10.1. If NO, are you a resident alien who is eligible and has applied for U.S. citizenship?
    • [-] Yes
      [—] No
      [X] This does not apply to me

11. Besides English, please list any languages that you are able to read, write, or speak in:

• Mexican Spanish

Page 2 of 6

12. List all high schools, colleges, and universities attended:

• Name of School: Los Santos High School
  Enrollment Term: 15/08/2006 to 23/06/2010
  Location: Los Santos, Los Santos County, San Andreas, United States
  Type of Degree Earned: DNA
  Major/Area of Study: DNA

13. Job Experience:

• Name of Employer: United States Marines
  Employment Term: 23/06/2010 to 01/08/2014
  Job Title/Rank: Infantry
  Duties/Assignments: Patrol

14. If you have served in the military, please indicate which branch:

• [—] Army
  [—] Navy
  [—] Air Force
  [X] Marines
  [—] Coast Guard
  [—] National Guard/Reserves
  [—] This does not apply to me

Page 3 of 6

15. Do you have a valid San Andreas driver's license?

• [X] Yes
  [—] No

16. Has your driver's license ever been suspended or revoked?

• [—] Yes
  [X] No
  
  • 16.1. If YES, explain (include when, where, and circumstances):
    • DNA

17. Have you received any traffic citations, excluding parking tickets within the past six months?

• [—] Yes
  [X] No

Page 4 of 6

18. Have you ever been detained by law enforcement for investigation, arrested, indicted, charged, or convicted of any misdemeanor or felony offense in this state or any other legal jurisdiction?

• [—] Yes
  [X] No
  
  • 18.1. If YES, explain each incident:
    • DNA

19. Are you aware of any pending criminal case(s) against you?

• [—] Yes
  [X] No

20. Have you ever used or experimented with any currently illegal drugs?

• [—] Yes
  [X] No
  
  • 20.1. If YES, give details including drug(s) used, most recent date, and circumstances:
    • DNA

21. When was the last time you drove while under the influence of alcohol or drugs?

• [X] Never
  [—] Within the last 6 months
  [—] Within the last 12 months
  [—] More than 12 months ago

22. Has your work performance ever been affected by your use of alcohol or drugs?

• [—] Yes
  [X] No

Page 5 of 6

23. I hereby certify that I have personally completed and initialed each page of this form and any attached supplemental page(s), and that all statements made are true and complete to the best of my knowledge and belief. I understand that any misstatement of material fact may subject me to disqualification; or, if I have been appointed, may disqualify me from continued employment.

Signature in Full: Samuel Velazquez

Page 6 of 6

24. Timezone (GMT):

• GMT-5

25. Provide a link to your LS-RP community forum account:

• ACCESS

26. Provide a link to your LSPD forum account confirmation post:

• ACCESS

27. List all current and past names under every character slot:

• Samuel Velazquez - Gerardo Gutierrez - Takagi Shotaro - Hideo Tanaka

28. Provide unedited screenshots for admin records for all of your characters:

• ((Lead Administrator))

29. Provide unedited screenshots of /stats on all of your characters:

• Samuel Velazquez — ((LSRP Lead Administrator))

30. Were you previously a member of the Los Santos Police Department?

• [—] Yes
  [X] No
  
  • 30.1. If YES, provide a link to your most recent reinstatement request:
    • DNA
    30.2. If YES, what was your character name, when did you leave the faction, and what was the nature of your leave?
    • DNA

31. Are you currently in an official faction?

• [—] Yes
  [X] No
  
  • 31.1. If YES, provide a link to your double faction approval:
    • DNA

32. Do you have TeamSpeak 3 and a working microphone?

• [X] Yes
  [—] No

33. Attach a copy of your character's background story:

• Spoiler: show

  Samuel Velazquez, a 26-year-old Los Santos native, carries the weight of both duty and tragedy on his shoulders. Motivated by the loss of his older brother, who unfortunately passed away in a gang-related shooting, he enlisted in the military, seeking to make a difference and focus on something other than his brother's passing. His time in the military, marked by discipline and courage, came to an end upon the honorable completion of his active-duty service term. Returning to his hometown, Samuel now seeks to join the Los Santos Police Department.
  
  With a deep understanding of the city and a unique perspective shaped by his military background, Samuel is hopeful to bring a blend of tactical prowess and empathy to law enforcement. His vow to honor his brother's memory and protect his community propels him forward as he prepares to embark on this new chapter.