Central Bureau of Investigation International Police Cooperation CELL 6th Floor, 5-B, CGO Complex Lodhi Road, New Delhi Sub:- Nomination for Police Chief of Staff, P-4 ( Seconded) in MINUSTAH - reg . Please find enclosed herewith a Message dt. 28-04-2015 received from Shri Raman Kumar, Under Secretary to the Government of India, New Delhi on the subject cited above for necessary action at your end as UN deputaion matter is being processed at CBI, HO level . Encl:- As above Pl/r3-/Y Assistant Director CBI/IPCC/New Delhi S13 (HQ), CBI, HO, New Delhi CBI I.D. No. / /1/2/2015 Dt P CI)) I 4- t . '75) •44" vet *1"1"1' a. V Office of the Director CBI NQW Delhi a2..c ...... Dy. No .. z From : POZtrfc c4 0 Date(. S URGENT AT ON . Home New Delhi 1. 2. -DIRECTOR CBI 1.4ENNI DELHI .... ...... - -,3SC 3. 4. 5. The Chief Secretaries and DsG (P)s of all States / UTs Directors - IB/CB1/SVPRA/SPG/NEPA/NICFS/CFSL/ DCPW/NCRB. DsG - BSF/CRPF/ITBP/CISF/NSG/RPF/BPR&D/SSB /NCB/NIA/Assam Rifles (Through LOAR) Commissioner of Police Delhi. UT Division, MHA No.21023/17/2015-PMA 9 APR 2015 Dated the ('Z g April, 2015 Subject :- Nomination for Police Chief of Staff, P-4 (Seconded) in MINUSTAH. 0)) UNDPKO through PMI to UN has sought the nomination of Individual Police Officers for the Post of Police Chief of Staff, P-4 (Seconded) in MINUSTAH for an initial period of one year with possibility of extension. :Not mentioned. Number of post Rai Dy. i,,:o...,P..5.e.7.7.7. P-4, [SP/DIG] Level of Post Organization MINUSTAH 12. Months (extendible) 'onth / ,05-.. Duration •. 2015-MINUSTAH-5180a-DPKQ _ _._ Job Opening number Date of submission of nomination to PMI to UN — 25th May, 2015. • 2..0.15- Qualifications: Education: Advanced University Degree (Master's or equivalent) in Law e nforcement, Criminal Justice, Public Administration, Human Resources Management, Logistics, Social Sciences or other relevant field. A first level university degree with a combination of relevant academic qualifications and extensive experience in law enforcement, including planning and administration may be accepted in lieu of the advanced university degree. Graduation from a certified police academy or other law enforcement training institution is also required. Work Experience: A minimum of ten (10) years of relevant progressive responsible experience in law enforcement in a national law enforcement agency at the strategic, operational and managerial level. At least seven (7) years of practical experience in such areas as police administration, human and/or financial resources managements, assets management, police policy development. Peacekeeping or other international experience in the UN or other organizations is desired. Familiarity with United Nations administrative policies and procedures is highly desirable. pi,N N 1/0 Office of DIG,SIPCU) Dy. No ....... 1 D .. Dated 1 i) . Languages: English and French are the working languages of the UN. For the post advertised, proficiency in oral and written English and French is required. Knowledge of another official language is an advantage. It is requested that nomination of eligible and willing officer of the level 2. of SP/DIG (P 4) may be submitted to this Ministry by 18th May 2015 along with the following documents duly completed in all respect:- United Nations Personal History Profile (PHP) form (P.11) duly completed and signed by the nominated candidate. United Nations Employment and Academic Certification [attachment to personal history profile (P-11)] Form duly completed and signed by the nominated candidate as well as the relevant local authority. iii. Personal details as per Annexure-l. 3. The nominated officers may be advised to send the above document as per the format enclosed through electronic mail at e-mail address (uspmanic.in or sopmanic.in). 4. No modified format other than the specimen enclosed will be entertained/accepted as it invites lot of observations from UN HQ (UNDPKO) while finalising the nominations. It may be ensured that the photographs of the officer applying for the post should be placed on the front side of P-11 form and signature in the last page at relevant place. 5. It may please be ensured that the nominees are clear from Vigilance angle. 6. No direct application will be entertained. ( Raman Kumar Under Secretary to the Government of India :23093443 — :23093750/2398 :uspma@nic.in 3 C opy to 1. Commissioner of Police Mumbai, Kolkatta, Chennai and Bangalore. 2. SO (IT), MHA - It is requested to forward the nominations of eligible and willing officers though State Government With the request to uplo etgl 'above communication on MHA website. ( Raman Kumar Under Secretary to the Government of India ) S'?:23093443 A:23093750/2398 \-1 BIO-DATA PROFORMA Annexure Recent passport size photograph 1. Name of Post applied. 2. Job opening number 3. Name of the Officer 4. Designation/Rank/organisation with present place of posting. 5. In the case of officers of deputation with other organization. (a) Name of Parent organization. (b) Name of organization presently employed. (c) Date of deputation (d) Expected date of repatriation to parent cadre/organization. 6. Date of Birth 7. Education/Qualification 8. Date of Joining Police Service 9. Service/Cadre/Batch 10. Educational Qualification 11. Previous UN experience Telephone No. a. Office b. Residence c. Mobile No d. Fax No. e. E-mail id I hereby certify that, I fulfill the eligibility requirement notified for the post applied for. (Signature of the applicant) 1/55; United Nations ---' Nations Unies K;S AP-?. 2 I P r. 312. 001833. DPKO/OROLSIND/2015/0604 The Secretariat of the United Nations presents its compliments to the Permanent Mission of Member State to the United Nations and has the honour to invite its Government to nominate Individual Police Officers in active service for appointment on secondment to the United Nations Stabilization Mission in Haiti (MINUSTAH) for a period of one year. This invitation is contingent to the final approval of the post, which is still ongoing. Any further contract extension can be granted on an exceptional basis provided there is a mission mandate requirement and the incumbent displays good perf.ormanec, dedication, professionalism and the achieved results. The final decision on the extension is subject to approval by the United Nations and concurrence by the national authorities. Details regarding the posits for which the Secretariat is seeking quail lied applicants are provided in the attached job opening #2015-M1NUSTAH -51806- . DPKO. Also attached are the "Application Procedures for United Nations Police Officers on Assignment with Peacekeeping` Operations or Special Political Missions". The Secretariat kindly requests the Permanent Mission to submit a separate application for each candidate, to the Police Division/OROLSI/DPKO, 01 Plaza DC1, Room 0716,, in accordance with the above-referenced procedures, certifying that the nominees meet the requirements as set forth in the attached job description's as well as in the "Guidelines for United Nations Police Officers on Assignment. with Peacekeeping Operations." Applications submitted after the deadline specified in the job description/8 will not be considered_ The Permanent Mission is also requested to confirm that selected candidates will be released, in a timely manner, from the national police service obligations for service with the United Nations. It is also requested to ensure that the rank of each candidate submitted is indicated on the. application. In addition, it is strongly reconunended that Member States carefully pre-screen their applicants and submit only.those candidates meeting all requirements for the position/s as described in the job opening/s. Member States are strongly encouraged to notninate qualified female police officers. Preference will be given to equally qualified women candidates. Should the Permanent Mission so agree, nominees may also-be considered for services with other United Nations peacekeeping or special political missions. The Secretariat would be most grateful if an indication to this eilect could be ave Ei) United Nations Nations Unies included in the submission. The Secretariat wishes to outline that it is the responsibility of the Government to ensure that each candidate it nominates has not been convicted of, or is not currently under investigation or being prosecuted for, any criminal or disciplinary offence, or any violations of international human rights law or o.no mi nees who have been international humanitarian law. In the casef investigated for, charged with or prosecuted for any criminal offence, with the exception of minor traffic violations (driving while intoxicated or dangerous or careless driving arc not considered minor traffic violations for this purpose), but were not convicted, the Government is requested to provide information regarding the investigation(s) or prosecutions concerned. the (.fovermnent is also requested to certify that it is not aware of any allegations against its nominated candidates that they have committed or been involved, by act or omission, in the commission of any acts that may amount to violations of international human rig lts law or international humanitarian The Secretariat recalls that the responsibilities of those personnel who are appointed to serve in United Nations .peacekeeping or special political missions are exclusively international in character= They perform their functions under the authority of, and in full compliance with, the instructions of the Secretary-General of the United Nations and persons acting on his behalf and arc duty-bound not to seek or accept instructions in regard to the performance of their duties from any government or from other authorities external to the United Nations. Seconded personnel should early out their fiinctions in accordance with all applicable regulations, rules and. procedures of the. Organization. The Secretariat of the United Nations avails itself of this opportunity to renew to the Permanent .MisSion of Member State to the United Nations the assurances of its highest consideration. 21 April 2 15 ft 41 NNN .s i United • 'Nf 441M efitligpyWosthamrequill . r #..:04*ilrei.*.#00,M0f ..4/?.#1#017Stat1/400 • Post title and level Organizational Unit Duty Station Reporting to Duration Deadline for applications Job Opening number Nations ':' qui eiz S11110)ialtliteu' ito 'SCr1.lat, - tiotitwe • NO•40 'ranee A.,.0 d,t004• $3 Police Chief of Staff, P-4 (seconded) United Nations Stabilization Mission in Haiti (MINUSTAII) Haiti Police Commissioner 12 Month (extendible) 25 May 2015 2015-MIN USTAH -51806- DPKO United Nations Core Values: Integrity, Professionalism and Respect for Diversity RESPONSIBILITIES: In compliance with the UN mandate and under the supervision and substantive guidance of the Police Conunissioner, the Police Chief of.Staff will be responsible for the adininiStrative and logistic support of the UN Police component inits performing mandates , tasks. The:Police. Chief of Staff will in particular coordinate the work of respective sections in the areas of personnel, logistics, fleet maintenance, legal advisory, conduct and disciplinary issues, public information and induction training for the new UNPOL arrivals. Within the limits of delegated authority, the Police Chief of Staff Will be responsible for, but not limited to, the performance of the following duties: • Managing respective UN Police Headquarters sections under his/her command; • Developing and updating administrative policy directives, plans and orders of the Police Commissioner, deployment plans, Standard Operating Procedures (SOP); preparing and publishing informational bulletins on new directives and instructions requiring the attention of all UN Police officers. • Supervising human resource management process: assisting in the determination of the appropriate assignments and providing recommendations to the Police Commissioner on the timely appointment of suitable personnel to key non - professional positions prior to the time when they become vacant; • Overseeing and monitoring the deployment of individual police officers and allocation ofrelated resources to meet operational requirements; • Ensuring the planning of UN Police officers rotations, tour of duty extensions, leave and CTO; coordinating and overseeing the movement: of personnel (MOP) within the Mission and outside the Mission; • Maintaining the personnel record tiling system: • Providing general .oversight of all assets belonging to the UNPOL component and their proper use by the component; • Maintaining permanent liaison with all. sections of the Mission Support component and international staff section regarding police requirements in terms of travel, deployment, accommodation, finance, offices, CITS, logistics, supply, constructions, etc. • Organizing legal advisory support to the. UN Police leadership and other UNPOL staff when necessary; • 1 rlsuring compliance with the United Nations rules, regulations, and Mission Mandate, conformity to the highest standards of professional conduct and personal behavior by the UNPOL, proper utilization of police resources under her/his command at all times including implementing regular inspection regimes and initiating corrective measures to improve efficiency and effectiveness. within UN police component and harmony with other mission components in the spirit of an integrated mission and attainment of common goals; • Overseeing coherent mission induction programs, for all the new UNPOL arrivals and exploring and facilitating additional, in-house training to the UNPOL members in collaboration with the mission Integrated Training Service (ITS); • In coordination with. and under the guidance of the DPKO/Pol ice Division, organizing the certifieation of Selection Assistance and Assessment 'learn (SHAT) members; nominating the above trainers for participation in SAAT sessions in Police Contributing Countries,. at the request of the DPKO/Police Division; • Conducting visits to Mission team sites to verify that morale is high, and work is being done in a fair and equitable manner and in .accordance with - Sound and progressive. management principles; • If necessary, carrying out internal investigations on allegations of misconduct by individual police officers and recommending relevant disciplinary action in e0Ordination with the Mission Disciplinary Unit; representing the 11N Police-on Boards of Inquiry; • Maintaining permanent administrative information exchange.between the UN Police component and the DPKO/Police Division; ensuring regular dissemination of UNPOL strength reports among the T_TNPOL staff, Mission leadership, the DPKO/Pol ice Division; • Performing any other dutieS as assigned by the Police Commissioner in fulfillment of the mandate. COMPETENCIES: Professionalism: Shows pride in .work and achievements; demonstrates professional competenee.and mastery of subject matter; is conscientious and efficient in mccting commitments, observing deadlines and achieving results; is motivated by professional rather than personal concerns; shows persistence when faced With difficult problems or challenges; remains cairn in stressful situations_ Takes responsibility for incorporating gender perspectives and ensures the equal participation of women and men in all areas of work. Outstanding expert knowledge in the technical field of work in general and in the, specific- areas being supervised in particular; strong organizational skills; experience in the Management and administration: ability to review and edit the work of others. Planning and organizing: Develops clear goals that are consistent with agreed strategies; identifies priority activities and assignments; adjusts priorities as required; allocates appropriate amount of time and resources for completing work; foresees risks and allows for contingencies when planning; monitors and adjusts plans and actions as necessary; uses time efficiently Communication: Speaks-and. writes clearly and effectively:- listens to others, correctly interprets messages from others and responds .appropriately; asks questionS to clarify, and exhibits interest in having two-way communication; tailors language, tone ; style and format to match audience; demonstrates opeanessin sharing information and keeping people informed. Communicates effectively with a wide range of international and national agencies, partners and people of different national and cultural backgrounds. Teamwork; Works collaboratively with colleagues to achieve organizational goals; solicits inputs by genuinely valuing - other's ideas and expertise; is willing to learn from others; supports and acts in accordance with final group decision, even when such decisions may not - entirely reflect _ own position; shares credit for team accomplishments and accepts joint responsibility for team shortcomings. QUALIFICATIONS: Education: Advanced University Degree (Master's or equivalent) in Law enforcement, Criminal Justice, Public Administration, Human Resources Management, I .ogistics, Social Sciences or other relevant field. A first level university degree with a .combination of relevant academic qualifications and extensive experience in law enforcement, including planning and administration may be accepted in lieu of the advanced university degree. Graduation from a certified police• academy or other law enforcement training institution is also required. Work Experience: A minimum of ten (10) :years of relevant. progressive responsible experience in law enforcement in a national law enforcement agency at the strategic, operational, and managerial level. At least seven (7) years of practical experience in such areas as police administration, human and/or financial resources managements, assets management, police policy development. .Peacekeeping or other international experience in the UN or other organizations is desired.'Familiaritywith United Nations administrative policies and procedures is. highly desirable. Rank: Lieutenant Colonel/ Chief or Senior Superintendent, equivalent .or higher. Languages: English and French are the working languages of the UN. For the post advertised, proficiency in oral and written English and French is required. Knowledge of another official language is an advantage. Preference will be given to equally qualified women candidateS. Date of Issuance: 20 April 201 5 htto://vvww.un.orkfen/peneelteenimdsitcs/oolice . APPLICATION PROCEDIllt PS FOR PROFESSIONA . CONTRACTED POSITIONS IN UNITED NATIONS POLICE COMPONENTS IN PEACFK MING OPERATIONS OR SPECIAL POLITICAL MISSIONS REQUIRING OFFICIAL. SECONDMENT FROM NATIONAL GOVERNMENTS OF UN MEMBER STATES Outlined below arc the procedures to he followed by Permanent Missions for the presentation of candidates to professional posts requiring secondment from active police service, which are open for recruitment within UN peacekeeping operations or special political missions. In the interest of promoting an orderly. .proceSs and to. avoid delay in the consideration of applications, Permanent Missions are respectfully requested to.adhere closely to these procedures: 1. The above mentioned posts are reserved only for candidates recommended by Member States through their Permanent MisSiOns to the United Nations. Candidates applying independently will not'be considered. It is requested that applications be submitted as soon as possible but not later than deadline specified in each Job Opening. announcement. Applications received after the deadline will not he considered. 2. All applications must be submitted in a duly completed typed (not hand-written) and signed United Nations Personal History Form (P.11.) along with Academic and Employment Certification Form (attachm ent. to P-11 form). Applications using other formats will not be accepted, but additional information may be attached to the P. 11. For the convenience of the Permanent Mission, a P-I 1 form and attachment are enclosed as samples to be photocopied as needed. 3. Selection, for service with the United Nations is made on a competitive basis. It is therefore essential that All the.Personal History Forms be completed. with a view to presenting; the candidates .qualifications and experiences as they relate to the requirements as set Out in the releVant Job Opening. In the event a Permanent Mission wishes to recommend a candidate for several posts, a separate Personal History Form should be submitted for each post. 4. In.aceordanee with the new Policy on Human Rights Screening of UN Personnel, all individuals who seek to serve with the United Nations, are requested to make "selfattestation" that s/he has not committed any serious criminal offences and has not been involved in violations of international human rights Or international humanitarian. law. The self-attestation natiSt be attached to the P-11 form and contain the following wording: [attest that I have not eorinnitted, been .convicted of, nor prosecuted for,. any criminal or disciplinary offence. I attest:that I have not been involved, by act or omission, in any violation .human rights law or international humanitarian law_ The applications withOut signed individual self-attestations will not be accepted. 5. Permanent Mission are requested to present their candidates in one single submission, in accordance with the ,dcadlinc date specified in the job Opening. wider cover of a note - verbale listing the names.of the candidates, post title(s) they are nominated for and the corresponding vacancy announcements. 6. Applications must be hand-delivered by-Permanent Mission to the Police Division Selection and RecruitmentSection, Office of Rule and Law and Security Institutions, Department of Peacekeeping Operations at 1- . UN Plaza, 7(11 floor, room DC1 -0776, in accordance with the specific directions in the relevant Note Verbale. 7. Upon delivery of the applications, the Selections and Recruitment Section will acknowledge the receipt to the individual making the delivery. 8. Communication regarding this process will be through the Permanent Mission only. The Secretariat will not entertain personal queries from individual applicants. April 2014 1 1)t) nOt WfitC. INSTRUCTIONS PERSONAL 'II IS' WRY fin t name Family name Maiden tame, ifmy Middle name Narinnali y(ie4) RI birth Place of birth 2. Date of (duy/month/yr) Ttirth 7. }Aright 8. Weight NATIONS UNITED Please answer each question clearly and completely. TYPE OR PRINT LEGIBLY. Read carefully and follow all directions, in This Space Present Nationality(ies) 1 6. Sas' Marital Status: Married ❑ Single ❑ Separated ❑ Widow(cr) Divorced ❑ Eon y into -United Nations service might require assigninent to any armor the world in which the United Nations might have revonsthittrics, YES 1::-.1 NO U (a) Are there any limitations on your ability to perform in your prospective field of work'? 'YT.S ❑ NO (b) Are there any limitations on your shalt!, to i,.. lem,e. in alt travel? 10. 9. p ❑ . 12. Permanent address Present address 13. 00 cc Telephone No. P1. Office Fax No, Telephone No. ( Telephoue/Fax No. ( ( E-mail: 15. Do you have any dependent children? 16. ❑ NO ❑ . information: If the answer is "yee", give the followtoz natc.of Birth (dayimo/year) Name of Children 15. (a) YES Place of Birth Nat ionaIily Gender blame of Spouse Have you taken up legal permanent residencT. tratus in Y any country other than that Of yo ► ir nationality! . NO El ifanswer"yt.hcoun? 17. 18. Have you taken any legal step. towards changing your present nationality? If answer is '"yes". explain fully: YES rl NO Ate any of yutet telatives employed by a puhticimernarlonal organiziition? YES ❑ If answer is -yes-, give the following -htionnallen: NAME R ela ti onsh ip 111 NO ❑ Name of International orminin ► rion 19. What is your preferred field of work? 20. Would you accept eni.plirynient fin less than Lk months? 21. 'lave you previously submitted an m.i) licatioa for employment and/or undergone any kids YES El NO 11 with YES NO U If so. when?' 2?. TaslOWL EDGE OF LANGIJAGPS, What is your mother tongue? OTHER LAMA 'AGES READ WRITE SPEAK UNDERSTAND Easily Not Pasily Not Easily Emily Fluently Nut Fluently Not Easily ❑ ❑ ❑ ❑ O 23. For clerical grades only halkore :ipeed in words per mtpute English Fiend) Other languages ❑ 0 ❑ O ❑ ❑ ❑ ❑ ❑ ❑ 0 0 ❑ ❑ List arty office machines or equipment and computer programmes you use. Typing Shorthand P.11 (7.03).R 2 24. EDUCATION, (rive till] (lentils -. A. I)niversity or equivalent NAME, PLACE AND COUNTRY Please give complete addiess. T'Icasc Ore exact titles of del.,ertes in original language. Plcu.ce do not ttanslate or equate to other degree;, ATTENDED FROM/ II) 1 Month/Year Month/Year n. SCHOOLS OR OTHER FORMAL TRAINING OR NAME, PLACE AND COUNTRY Please Aivc Complete address. TYPE DEGREES and ACAOE.MIC MAIN COI Itts F. OF STUDY DISTINCTIONS 013TAINED EDUCATION FR OM AGE 14 (e.g., high school tcebniCal selfoo: or Upprenticeship) YEARS ATTENDED CERTIFICATES OR nrmomAs OLSIAINEL) FROM TO 23. LIST PROFESSIONAL SOCIF:TTRS AND ACTIVITIES 26. LIST ANY SIGNIFICANT PUBLICATIONS YOU HAVE WRII -IF„N (DO NOT /ITTACI1) 27. EMPLOYMENT RECORD; Starting with von,. present post list in REVERSP. ()Rm.): 'very employment you have kw!, the a separate block for each p o:ir. Include also service in the urmed forces and note any period during which you were not }itain.Cully employed. If you need tixOrt spa, attach additional pages the Mlle Size. Give both gross and net sslariee per animal for your last or pretent post. A. IN CIVIC, PUBLIC OR INTERNATIONAL AFFAIRS- - PRESENT POST (LAST POST, IF NOT PRESENTLY IN EMPLOYMatT) FROM MONTH/YEAR MONTH/YFAR STARLING SALARIES PER ANNUM FINAL NAME Of EMPLOYER: TYPE OF BIISINF.SS ADDRESS OP EMPLOYER NAMH.OF SUPERVISOR EXACT TM OF YOUR POST: NO. AND KIND OF EMI'LOYEES SUPERVISED BY YOU: REASON FOR LEAVING DESCRIPTION OF YOUR DITUFS: l'. 1 1 r1.(1 1 )-E 3 B. PREVIOUS POST3 (IN REVERSE ORDER FROM TO MONTI-I/YEAR MONTH/YEAR SALARIES PF.R ANNUM STA.RTINC EXACT TITLE OF YOUR POST: FINAl. , NAME OF EMPLOYER: TYPE OF RUMNESS: ADDRP.SS OF EMI'LOYER'. NAME OF SUPERVISOR NO. AND KIND OF EMPT.OYEES SUPERVISED BY YOU: ' REASON FOR LE A VINO • DESCRIPTION OF YOUR DUTIES • . FROM TO MONTH/YE A.R MONTI.1./YEAR SALARIES PER ANNUM STARTING 'EXACT TITLE OF YOUR POST; FINAL NAME OF EMPLOYER: TYPE.'OF BUSINF.SS; ADDRESS OF F.MPI.0 YEW NAME. OF SUPERVISOR: -NO. ANDKIND OF F.MPI .0YEES SUPERVISED BY YOU: REASON FM. LEAVING: DESCRIPTION OF YOLfR.vij Illis FROM TO MONTH/YEAR MONTIT/YEAR SALARIES STARTING PER ANNUM EXAC.I TITI .F. OF YOUR POST: FINAL NAME OF EMPLOYER: TYPE OF 'BUSINESS: AI >DRESS OF EMPLOYER. NAME OF SUPERVISOR: NO. AND KIND OF EMPLOYEES SUPER V ISEP BY YOU: DEScRIPTION REASON FOR LEAVING. OF YOUR DUTIES • P.11 (7-11:9•ii 4 215. HAVE YOU ANY 0I-3JECTIONS TO OUR MAKINti INQUIRIbS OF \mug P.RESENT EMPLOYER? Yt..:S 29. ARE YOI I NOW OR I lAvii YOU EVER BEEN A CIVIL SLRVANT IN YOUR GOVERNMENT'S EMPLOY? If zttavvr.t - is - 'yes", WHEN? 10 . 1.o not ?veal name's of superviyort illird tinder _____--- '.0.. NO ❑ YES F.] N0 -111 PFFFIzriNCES: List three Persons, Not relAtefl to yon. and arc not cturcai 'jolted Notiuns :tuff members, who are familia with your chno2.c.tcl mat qualifications. 1k171 27. F111.1. ATMREss PULL NAME 3I a BUSINESS OR OCCUPATION ---- STATE ANY °TITER RTLEVANT !'ACTS. INCT.UDE INFORMATION R.EGARDINO ANY RESIDENCE OUTSIDE TfrIE C:OUNIRY OF YOUR NATIONALITY. HAVE YOU EVER BEEN ARRFSMD, INDICTED, OR SIIMMON.ED INTO COURT AS A Dr1113NDANT IN A CRIMINAL PROCEI2DING, OR CONVICTED. FiNED OR IMPRISONED FOR TILE VIOLATION OF ANY LAW (excluding minor Traffic violations)? YES ❑ NO ❑ If "ye", give full particulars of each case In an attached stinernenr_ 33. OTHER AGENCIES OF THE UNITED NATIONS SYSTEM: MAY BE INTERESTED IN OUR APPLICANTS, DO YOU HAVE ANY OBJECTION •11) YOUR PERSONAL HISTORY FORM BEING MADE AVAILABLE 10 THEM? YES ❑ NO. ❑ 34. I certify that the statements made by me in answer to the foregoing questions are true, Complete and correct to the best of my knowledge and belief. ',understand that any miiirepre§en4ition or material omission made on a Personal History form or other document rcqueNted by the Organization renders a staff member of the United Nations liable to termination or dismissal. DATE, (day, month, yeat) N.B. You will be requested to SIGNATURE: Abpply documentary evidence which supports the statements you have made above. Do not, however, send any docinuentaty evidence until.Yon have been asked to do soby the Organization and, in. any event, do not submit The original texts of references or testimonials unless they have been obtained for the sole use of the Organization. P.11 (7-03)-F UNITED NATIONS Employment and Academic Certification Attachment to Personal history Profile (P11) TO BE COMPLETED BY CANDIDATF: Personal Data; Middle names: Given name: Family Name: Gender: MN elnail address: Position for wbieb .you are applying:, Note: If nu Aru applying for more than one position, please submit separate P11 and Pil attachment for (trick Job opening) Job 0 coin Number: _ Military Service history/Police Service History Date of. Commission (for military officers) or-date of enlistment/entry to SCrviee (for police officers): Date Last Promoted Current rank Date eligible fin.' Projected Retirement date from current promotion to next rank rank Branch/C.orp/Mustering Sub Specialisation/additional qualifications Degrees and Academic Distinctions Obtained:. 1 al QN, NAME. of PLACP AND COUTNRY. Please give complete address. Graduation from the Staff/ War College or Pollee Academy (and/or similar law enrol-cement institution) University Degree/s ATTENDED: FROM: TO; tkonth/Year Montli/Year DEGREES and ACADEMIC DISTINCTIONS OBTAINED Experience in peacekeeping operations: S. ecify_1.11,4 or other International Ex erlence, startins with your most recent experience and list in Dates nim/yy-mni/yy Mission/ Position/title Operation/I ocation (Milob, I IQ Staff; Contgt, Advisor) reverse order Description of duties Command Everience, starting with your mug recent experience and liyt . in reverse order Dates rum/yy-mnilyv Unit/Position/Org Significant W•it. Activities Significant Planning Eperience. start in with .uur most recent experience and list in reverse nrde.r 0 elution/Activity Dates ninil,g-inni/yy Position/Or (Other) International Exposure other than peace keeping operations, starting with your most recent experience and list in reverse order Date: mrrilyy-mnilyy Position/Org Function/Activity Military and/or Police Trainin Cotirses/Seininars: (lust two year) Name of Course Date: mm/yy • -.uut/yy Institution. Additional Commerifk: I certify that the statements crude by mein answer to the foregoing questions are complete and correct. I understand that any misrepresentation or material omission made on arerSonni History Corwin - other document requested by the Organization renders a staff member for the Linked Nations liable ineligible for further consideration. I declare that I have never committed, boon convicted of and am not currently under investigation or being prosecuted for any criminal, human rights, civil action or disciplinary offence, with the exception of minor traffic violations (driving while intoxicated or dangerous or car4less driving am not consideredminor traffic violations for this purpose). I declare that I have not been involved, by act or omission, in the commission of any violation of international human rights law or international humanitarian law. I am not able to attest to the proceeding paragraphs for the following reasons: Date Signature You will be requested to supply documentary evidence which supports the statements you have made above. Do not. however, send any documentary eVidenee until you have been asked to du so. by the pipui:Lation and, in any event, do not Submit the original tracts of references ur testimonials unless they have been obtained tot the sole use of the Organization. N.B. TO BE COMPLFTED BY THE RELk• rANT LOCAL AU111URITY: On 1701111ot. is complete and correct. 1 certify that the InfOrmation provided by I further certify that the nominated candidate has never been convicted of, or is not currently under investigation or being prosecuted for, any criminal or digniplinao , offence, or env violations. of international human rights law, civil action or disciplinary offence. The Government of is not aware of any allegations against the nominated candidate that she/he has committed or been involved, by act or omission, in the commission of any acts that may amount to violations of international human rights law or international humanitarian law. In the case of the nominee who has been investigated for, charged with or prosecutedfOr any criminal offence, with the exception of- minor traffic violations (driving while intoxicated or dangerous or careless driving are not considered minor traffic violations for this purpose), but was not convicted, the Government is requested to provide infbrmation regarding the InvestigationN or prosecutions concerned. Date.. Official Stamp
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