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Free Ohio Hls 0037 Template

The Ohio Hls 0037 form, provided by the Ohio Department of Public Safety Division of Homeland Security, is a critical document that individuals seeking public employment must fill out. It functions as a declaration regarding whether or not the applicant has provided material assistance to a terrorist organization or one that supports terrorism, as identified by the U.S. Department of State Terrorist Exclusion List. Failure to accurately disclose such assistance or knowingly making false statements on this form is considered a felony of the fifth degree, underscoring the form's significance in maintaining public safety and security.

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In an era where security concerns are paramount, the Ohio Department of Public Safety’s Division of Homeland Security introduces the HLS 0037 form, a crucial document for public employment candidates. This form demands a declaration regarding material assistance/non-assistance to a terrorist organization, underscoring Ohio’s adherence to stringent security measures in alignment with Section 2909.34 of the Ohio Revised Code. Candidates are required to assert whether they have provided support, in any form exceeding one hundred dollars, to entities listed on the U.S. Department of State Terrorist Exclusion List—a comprehensive catalog available through the Ohio Homeland Security Division website. A meticulous vetting of responses ensures that any affiliation or support for terrorism-related activities is promptly identified, with failure to honestly disclose such information or providing false statements being treated as a fifth-degree felony. Designed to filter the provision of support to terrorist endeavors, the form addresses a series of probing questions requiring honest, yes-or-no answers, focusing on membership, persuasion efforts, solicitation of funds or assistance, and any direct or indirect material support. This necessary declaration plays a pivotal role in safeguarding public employment from potential security risks, maintaining the integrity of Ohio’s Homeland Security efforts. Completing this form truthfully and in its entirety is not just a prerequisite for potential employment but a responsibility shared by all applicants, underscoring the collective commitment to security and protection against terrorism.

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Ohio Department of Public Safety

Division of Homeland Security

http://www.homelandsecurity.ohio.gov

PUBLIC EMPLOYMENT

In accordance with section 2909.34 of the Ohio Revised Code

DECLARATION REGARDING MATERIAL ASSISTANCE/NONASSISTANCE TO A TERRORIST ORGANIZATION

This form serves as a declaration of the provision of material assistance to a terrorist organization or organization that supports terrorism as identified by the U.S. Department of State Terrorist Exclusion List (see the Ohio Homeland Security Division website for a reference copy of the Terrorist Exclusion List).

Any answer of “yes” to any question, or the failure to answer “no” to any question on this declaration shall serve as a disclosure that material assistance to an organization identified on the U.S. Department of State Terrorist Exclusion List has been provided. Failure to disclose the provision of material assistance to such an organization or knowingly making false statements regarding material assistance to such an organization is a felony of the fifth degree.

For the purposes of this declaration, “material support or resources” means currency, payment instruments, other financial securities, funds, transfer of funds, and financial services that are in excess of one hundred dollars, as well as communications, lodging, training, safe houses, false documentation or identification, communications equipment, facilities, weapons, lethal substances, explosives, personnel, transportation, and other physical assets, except medicine or religious materials.

LAST NAME

 

 

 

FIRST NAME

 

 

 

MIDDLE INITIAL

 

 

 

 

 

 

 

 

 

HOME ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

 

STATE

 

ZIP

COUNTY

 

 

 

 

 

 

 

 

HOME PHONE

 

 

WORK PHONE

 

 

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DECLARATION

In accordance with division (A)(2)(b) of section 2909.32 of the Ohio Revised Code

For each question, indicate either “yes,” or “no” in the space provided. Responses must be truthful to the best of your knowledge.

1.Are you a member of an organization on the U.S. Department of State Terrorist Exclusion List? Yes No

2.Have you used any position of prominence you have with any country to persuade others to support an organization on the U.S. Department of State Terrorist Exclusion List?

Yes No

3.Have you knowingly solicited funds or other things of value for an organization on the U.S. Department of State Terrorist Exclusion List?

Yes No

HLS 0037 2/06

PUBLIC EMPLOYMENT - CONTINUED

4.Have you solicited any individual for membership in an organization on the U.S. Department of State Terrorist Exclusion List?

Yes No

5.Have you committed an act that you know, or reasonably should have known, affords "material support or resources" to an organization on the U.S. Department of State Terrorist Exclusion List?

Yes No

6.Have you hired or compensated a person you knew to be a member of an organization on the U.S. Department of State Terrorist Exclusion List, or a person you knew to be engaged in planning, assisting, or carrying out an act of terrorism?

Yes No

In the event of a denial of public employment due to a positive indication that material assistance has been provided to a terrorist organization, or an organization that supports terrorism as identified by the U.S. Department of State Terrorist Exclusion List, a review of the denial may be requested. The request must be sent to the Ohio Department of Public Safety’s Division of Homeland Security. The request forms and instructions for filing can be found on the Ohio Homeland Security Division website.

CERTIFICATION

I hereby certify that the answers I have made to all of the questions on this declaration are true to the best of my knowledge. I understand that if this declaration is not completed in its entirety, it will not be processed and I will be automatically disqualified. I understand that I am responsible for the correctness of this declaration. I understand that failure to disclose the provision of material assistance to an organization identified on the U.S. Department of State Terrorist Exclusion List, or knowingly making false statements regarding material assistance to such an organization is a felony of the fifth degree. I understand that any answer of “yes” to any question, or the failure to answer “no” to any question on this declaration shall serve as a disclosure that material assistance to an organization identified on the U.S. Department of State Terrorist Exclusion List has been provided by myself or my organization.

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Signature

Date

Document Specifications

Fact Name Detail
Governing Law Ohio Revised Code, specifically sections 2909.34 and 2909.32(A)(2)(b)
Purpose of the Form Declaration regarding material assistance/nonassistance to a terrorist organization
Key Definition “Material support or resources” includes currency, financial services, lodging, training, weapons, transportation, and other physical assets over one hundred dollars, except medicine or religious materials.
Penalty for Non-compliance or False Statements A fifth degree felony charge for failure to disclose or knowingly making false statements about material assistance to a terrorist organization
Reference List U.S. Department of State Terrorist Exclusion List available on the Ohio Homeland Security Division website
Review Process Allows for a review request upon denial of public employment due to indicated provision of material assistance to a terrorist organization

How to Use Ohio Hls 0037

Filling out the Ohio HLS 0037 form is a critical step in ensuring compliance with specific legal requirements related to public employment within the state. This document is designed to disclose any potential material assistance provided to terrorist organizations, as classified by the U.S. Department of State Terrorist Exclusion List. It's imperative to approach this form with honesty and diligence, as any misrepresentation can carry severe penalties. The following instructions will guide you through each section of the form to ensure it is completed accurately and efficiently.

  1. Start by visiting the Ohio Homeland Security Division website to review the U.S. Department of State Terrorist Exclusion List. This is crucial for accurate completion of the form.
  2. Enter your last name, first name, and middle initial in the designated spaces at the top of the form.
  3. Provide your home address, including city, state, ZIP, and county in the fields provided.
  4. Fill in your home phone number and work phone number in the appropriate spaces, including the area code.
  5. For each question in the declaration section, mark either “yes” or “no” in the space provided next to the questions. Ensure your answers are honest and based on the best of your knowledge.
    • Question 1 asks about membership in an organization on the Terrorist Exclusion List.
    • Question 2 inquires about using a position of prominence to support such an organization.
    • Question 3 pertains to soliciting funds or other things of value for these organizations.
    • Question 4 asks about soliciting individuals for membership in these organizations.
    • Question 5 concerns acts that provide material support to these organizations.
    • Question 6 asks if you’ve hired or compensated someone known to be a member of such organizations or involved in acts of terrorism.
  6. Review your answers to ensure honesty and accuracy. Missing or false information can lead to automatic disqualification and legal consequences.
  7. Sign and date the form at the bottom to certify that your answers are true to the best of your knowledge. Your signature acknowledges your understanding of the legal responsibilities indicated in the certification section.
  8. After completing the form, review it once more to ensure all sections are filled out completely.
  9. Submit the form as directed by the employer or agency requesting its completion. Keep a copy for your records.

After the submission, if a denial of public employment is faced due to indications of material assistance provided to an organization on the Terrorist Exclusion List, a review request can be made to the Ohio Department of Public Safety’s Division of Homeland Security. This action underlines the importance of transparency and accuracy in completing the Ohio HLS 0037 form.

Crucial Questions on This Form

What is the purpose of the Ohio HLS 0037 form?

The Ohio HLS 0037 form is used by the Department of Public Safety's Division of Homeland Security to collect declarations from individuals regarding whether they have provided material support or resources to a terrorist organization, as identified by the U.S. Department of State Terrorist Exclusion List. This is a requirement for individuals seeking public employment in Ohio, in compliance with section 2909.34 of the Ohio Revised Code.

Who needs to fill out this form?

Anyone applying for public employment in the state of Ohio is required to complete the HLS 0037 form. This ensures that individuals who have supported terrorist organizations are identified in the hiring process.

What constitutes “material support or resources” according to this form?

Material support or resources include a wide array of support such as currency, payment instruments, communications, lodging, training, safe houses, false documentation, weapons, and transportation, exceeding one hundred dollars in value. However, medicine and religious materials are explicitly excluded from this definition.

What happens if I answer “yes” to any of the questions on the form?

Answering “yes” to any question, or failing to answer “no,” on the HLS 0037 form indicates that you have provided material support to a terrorist organization. This may lead to your disqualification from public employment, as it flags a potential violation of the guidelines stipulated by the Ohio Department of Public Safety.

Can I appeal a denial of employment if it was based on my responses to the HLS 0037 form?

Yes, individuals who are denied public employment based on their responses can request a review of the denial. This request must be sent to the Ohio Department of Public Safety’s Division of Homeland Security, and the necessary forms and instructions for making this request are available on their website.

Is there a penalty for providing false information on this form?

Yes, knowingly providing false information or failing to disclose material support provided to any organization listed on the U.S. Department of State Terrorist Exclusion List is a felony of the fifth degree under Ohio law.

What should I do if I’m unsure how to answer a question on the form?

If you are unsure about how to answer a question, it's advisable to seek clarification from the Ohio Department of Public Safety or consult with a legal advisor. Providing accurate information is crucial, as false statements can result in legal consequences.

Where can I find the U.S. Department of State Terrorist Exclusion List for reference?

The Terrorist Exclusion List can be found on the Ohio Homeland Security Division website. It is important to review this list carefully before completing the HLS 0037 form to ensure compliance with its declarations.

Common mistakes

Filling out the Ohio HLS 0037 form requires attention and accuracy. Unfortunately, some common mistakes can lead to unnecessary complications or even legal issues. Here are ten common errors to avoid:

  1. Not reviewing the Terrorist Exclusion List – Applicants often overlook the necessity of checking the U.S. Department of State Terrorist Exclusion List against their personal or organizational affiliations.
  2. Skipping questions – Every question on the form must be answered with a “yes” or “no”. Leaving a question unanswered can result in automatic disqualification or further scrutiny.
  3. Incomplete personal information – The form requires your full name, home address, phone numbers, etc. Failing to provide complete and accurate information can delay processing.
  4. Misunderstanding the definition of “material support or resources” – Applicants sometimes misunderstand what qualifies as material support, leading to incorrect answers. It's crucial to consider the broad definition provided in the form.
  5. Signing without certification – The certification section confirms the truthfulness of your answers. Signing the form without reading or understanding this section can have legal consequences.
  6. Incorrectly assessing one’s actions or affiliations – Misjudging or underestimating one's connections or actions related to organizations on the Terrorist Exclusion List can lead to inadvertent misreporting.
  7. Failure to disclose relevant information – Omitting or hiding information about providing material support to listed organizations is a felony. Honesty is paramount when completing this declaration.
  8. Assuming the form doesn’t apply to them - Some individuals mistakenly think the questions are only relevant to certain professions or levels of public employment, which is not the case.
  9. Not keeping a copy of the completed form – It’s advisable to keep a copy of the filled-out form for your records. This can be helpful if there are any questions or if a review of your denial is requested.
  10. Rushing through the form without careful consideration – This form requires thoughtful responses. Rushing can lead to mistakes or inaccurate answers.

By avoiding these mistakes, applicants can ensure their Ohio HLS 0037 form is accurately completed, potentially saving time and avoiding legal issues.

Documents used along the form

Completing the Ohio HLS 0037 form, related to the declaration regarding material assistance/nonassistance to a terrorist organization, is an important step for individuals seeking public employment or engaging with the Ohio Department of Public Safety. Along with this form, there are several other documents and forms that are frequently used to ensure thorough compliance and understanding of one's legal obligations. These documents play a vital role in providing a comprehensive framework for legal and procedural clarity.

  • Background Check Authorization Form: This form grants permission to employers or state agencies to conduct a criminal background check. It is crucial for assessing an individual's eligibility for public employment, ensuring that they have not been involved in activities that would disqualify them from serving in a public capacity.
  • Ohio Ethics Commission Financial Disclosure Form: Public employees and certain candidates for public office in Ohio are required to disclose their financial interests. This transparency helps prevent conflicts of interest in public service by making financial interests known to the Ohio Ethics Commission.
  • Employment Eligibility Verification (I-9 Form): This federal form is used by employers to verify an employee's identity and eligibility to work in the United States. It is a standard requirement for all employees, including those in public service, to ensure they are legally allowed to work.
  • State of Ohio Tax Withholding Form: This document allows employees to specify their tax withholding preferences to ensure the correct amount of state income tax is deducted from their paychecks. It is an essential form for managing an individual’s state tax liability.

Together with the Ohio HLS 0037 form, these documents create a robust framework for ensuring individuals seeking public employment are thoroughly vetted and legally compliant. By completing and providing all relevant information required by these forms, applicants demonstrate their commitment to transparency and accountability in public service. Ensuring all paperwork is accurately filled out and submitted is crucial for a smooth hiring process and for fulfilling one's legal obligations in the state of Ohio.

Similar forms

The Security Clearance Form, used in various federal agencies, shares similarities with the Ohio HLS 0037 form in its purpose of assessing an individual's trustworthiness and potential security risks. Both documents require the declarant to disclose affiliations or actions that might pose a security risk; in the case of the HLS 0037 form, the focus is on connections to terrorist organizations, while security clearance forms more broadly assess associations or behaviors that could affect national security.

Employment Eligibility Verification Form I-9 is another document that, like the Ohio HLS 0037 form, is mandated by government regulation to ensure compliance with employment laws. While the I-9 form is designed to verify the eligibility of employees to work in the United States by confirming their identity and employment authorization, the HLS 0037 specifically seeks disclosures concerning any material support provided to terrorist organizations, aiming to prevent individuals who may pose a security risk from gaining public employment.

The Foreign Influence Questionnaire, often used in contexts requiring a high level of security clearance, has parallels with the Ohio HLS 0037 form in terms of scrutinizing an individual's connections to foreign entities. Both documents require individuals to disclose activities, relationships, or transactions that could suggest a conflict of interest or a security threat. The Ohio form specifically asks about material support to terrorist organizations, reflecting a concentrated concern about national security risks.

The Volunteer Application Form for Non-Profit Organizations, while generally less focused on security concerns compared to the HLS 0037, similarly requires applicants to provide personal information and often to answer questions regarding their background that could affect their suitability for a role. Just as the Ohio form seeks to mitigate security risks in public employment by identifying potential links to terrorism, a volunteer application aims to protect the organization's integrity and clientele by vetting volunteers.

The Financial Disclosure Form, required in many contexts from government positions to certain financial roles in the private sector, also shares objectives with the Ohio HLS 0037 form. Both types of documentation seek transparency from the individual regarding aspects of their personal or professional life that could present conflicts of interest or ethical concerns; in the HLS 0037's case, this takes the form of disclosing material support to terrorist organizations.

The Licensing Application Forms for professionals such as lawyers, doctors, and real estate agents, often include sections that require the disclosure of past criminal activity, ethical violations, or other conduct that could impact the applicant's credibility and reliability. Similarly, the Ohio HLS 0037 form mandates disclosures related to material assistance to terrorists, aligning the purpose of protecting public welfare and trust in both scenarios.

Last but not least, the Government Grant Application forms share a resemblance with the Ohio HLS 0037 form in the necessity of disclosing certain types of information that could affect eligibility. Just as grant applications may require applicants to disclose financial, legal, or ethical issues that might impact their trustworthiness or the viability of the project proposed, the HLS 0037 form focuses specifically on disclosing ties to terrorism as a criterion for eligibility in public employment.

Dos and Don'ts

When completing the Ohio HLS 0037 form, it's essential to proceed with attention to detail and understanding of the gravity this form encompasses. This declaration impacts employment eligibility within public service sectors in Ohio, specifically concerning material assistance to terrorist organizations. Below are the dos and don'ts to consider while filling out this critical document.

  • Do ensure all personal information is accurate and up to date. This includes your full name, home address, and contact numbers.
  • Do carefully read each question before answering, understanding that your responses must be truthful and reflect your best knowledge.
  • Do review the U.S. Department of State Terrorist Exclusion List available on the Ohio Homeland Security Division website to fully understand which organizations are included.
  • Do complete every question on the form. Leaving a question unanswered can lead to automatic disqualification from public employment consideration.
  • Don't provide false statements or withhold information about material assistance to organizations on the Terrorist Exclusion List. Remember, doing so is a felony of the fifth degree.
  • Don't rush through the form without considering the implications of your answers. Each response should be considered and accurate.
  • Don't forget to sign and date the declaration at the end of the form. An unsigned declaration is incomplete and will not be processed.
  • Don't hesitate to request a review of your denial, should that occur, by following the instructions provided on the Ohio Homeland Security Division website.

Completing the HLS 0037 form with honesty and precision is a pivotal step in ensuring the safety and integrity of Ohio's public employment sector. It's a responsibility that should be undertaken with seriousness and integrity.

Misconceptions

There are several common misconceptions about the Ohio HLS 0037 form, a crucial document within the Ohio Department of Public Safety's Division of Homeland Security. Understanding these misconceptions is essential for individuals and organizations aiming to complete this form accurately and in compliance with Ohio law.

  • Misconception 1: The HLS 0037 is only relevant for those who have direct connections with terrorist organizations. Contrary to this belief, the form is a declaration regarding any material assistance/nonassistance to a terrorist organization, impacting a wide range of activities and financial transactions that might not seem directly connected at first glance.
  • Misconception 2: Only large transactions are of concern. The form specifies that material support includes financial transactions "in excess of one hundred dollars." This underlines that not just substantial funds or contributions are of interest but also relatively small amounts that exceed this threshold.
  • Misconception 3: The declaration is a one-time requirement. The evolving nature of international relations and the consequent updates to the U.S. Department of State Terrorist Exclusion List mean that individuals and organizations must stay informed and possibly update their declarations as relevant.
  • Misconception 4: Any "yes" response will automatically disqualify you from public employment. While it's true that affirmative answers require further scrutiny, there is a process in place for reviewing denials based on provided information, allowing for a more nuanced assessment of the situation.
  • Misconception 5: The form is only for individual assessment. While the form requires personal information, it clearly queries about actions taken by oneself or one's organization, making it a document that assesses both personal and, by extension, organizational conduct.
  • Misconception 6: Filling out the form accurately guarantees clearance. Completing this form truthfully is necessary; however, it is part of a broader vetting process. There can be other factors or information examined by the Ohio Department of Public Safety’s Division of Homeland Security that influence the final decision.

Understanding these misconceptions about the Ohio HLS 0037 form helps in recognizing the importance of thorough and accurate completion. It's not just about assessing one's direct links to terrorism but involves comprehensively evaluating one's financial transactions, organizational affiliations, and broader actions in relation to identified terrorist organizations. Proper awareness and comprehension of these nuances are key to avoiding the legal repercussions of incomplete or inaccurate submissions.

Key takeaways

When filling out the Ohio HLS 0037 form, it’s crucial to understand its purpose and the consequences of your answers. Here are ten key takeaways to guide you through the process:

  • The form is a declaration regarding material assistance/non-assistance to a terrorist organization, as per section 2909.34 of the Ohio Revised Code.
  • It requires the disclosure of material assistance to organizations identified by the U.S. Department of State Terrorist Exclusion List. A reference copy of this list is available on the Ohio Homeland Security Division website.
  • Material support or resources include a wide range of items such as currency, communications, lodging, training, and even transportation, excluding medicine or religious materials.
  • You need to answer each question truthfully with a "yes" or "no." Any untruthful response or the omission of a "no" answer is considered a disclosure of material assistance to a terrorist organization.
  • Not disclosing material assistance or knowingly providing false statements regarding such assistance is classified as a felony of the fifth degree.
  • If you face a denial of public employment due to a positive indication of providing material assistance to a terrorist organization, you have the right to request a review of the denial. Details on how to request a review are provided by the Ohio Department of Public Safety’s Division of Homeland Security.
  • Completing the form entirely is mandatory for processing. Incomplete forms will result in automatic disqualification.
  • The accuracy of the information provided in the form is your responsibility. This includes understanding that any "yes" answer or failure to provide a "no" to any of the questions indicates the provision of material assistance to a terrorist organization.
  • When signing the certification at the end of the form, you are affirming that all your responses are true to the best of your knowledge, confirming your awareness of the legal implications of your disclosures.
  • Given the serious legal implications and potential for felony charges, it's important to consult the Terrorist Exclusion List carefully and consider the definitions of material support or resources to ensure accurate reporting on the form.

Understanding these key points is crucial for accurate and truthful completion of the HLS 0037 form, ensuring compliance with Ohio laws and contributing to the security measures in place to prevent terrorism.

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