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The Ohio HLS 0037 form is a critical document designed to ensure transparency and accountability in public employment. It specifically addresses the issue of material assistance to terrorist organizations, as defined by the U.S. Department of State's Terrorist Exclusion List. This declaration requires individuals to answer a series of questions truthfully regarding their affiliations and actions related to such organizations. A "yes" answer to any of the questions indicates a disclosure of material assistance, which could have serious legal implications. The form outlines the types of material support that are considered relevant, including financial resources, training, and transportation, while explicitly excluding certain items like medicine and religious materials. Failure to complete the form accurately can result in disqualification from public employment and may lead to felony charges. Additionally, if an applicant is denied employment based on their responses, they have the right to request a review from the Ohio Department of Public Safety’s Division of Homeland Security. This process underscores the importance of the form in safeguarding public safety and maintaining the integrity of public service roles.

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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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Form Specifications

Fact Name Details
Governing Law This form is governed by section 2909.34 of the Ohio Revised Code.
Purpose The form is used to declare any material assistance to terrorist organizations as defined by the U.S. Department of State.
Material Support Definition Material support includes financial resources, training, and other forms of assistance, but excludes medicine or religious materials.
Felony Penalty Failure to disclose assistance or making false statements can result in a felony of the fifth degree.
Disclosure Requirement A "yes" answer or failure to answer "no" discloses material assistance to a terrorist organization.
Review Process If public employment is denied, a review request can be submitted to the Ohio Department of Public Safety.
Signature Requirement The form must be signed to certify the accuracy of the provided information.
Contact Information Home and work phone numbers must be provided for contact purposes.

Ohio Hls 0037: Usage Guidelines

Completing the Ohio HLS 0037 form is a crucial step in ensuring compliance with state regulations regarding public employment. It is essential to provide accurate and truthful information. After filling out the form, it will be submitted to the appropriate authorities, who will review the declaration as part of the employment process.

  1. Begin by entering your last name in the designated space at the top of the form.
  2. Next, fill in your first name and middle initial in the respective fields.
  3. Provide your home address, ensuring that you include the street address, city, state, and zip code.
  4. Indicate your county of residence in the appropriate box.
  5. List your home phone number and work phone number in the provided spaces.
  6. Proceed to the declaration section. For each question, select either “yes” or “no” based on your situation. Make sure your responses are honest and accurate.
  7. Complete all six questions regarding your affiliation and actions related to organizations on the U.S. Department of State Terrorist Exclusion List.
  8. After answering all questions, review your responses to ensure completeness and accuracy.
  9. In the certification section, sign your name and enter the date to confirm that all information is true to the best of your knowledge.

Your Questions, Answered

What is the Ohio HLS 0037 form?

The Ohio HLS 0037 form is a declaration required by the Ohio Department of Public Safety’s Division of Homeland Security. It is used to disclose any material assistance or support provided to organizations identified on the U.S. Department of State Terrorist Exclusion List. This form is necessary for individuals seeking public employment in Ohio.

Who needs to fill out the Ohio HLS 0037 form?

Individuals applying for public employment in Ohio must complete the Ohio HLS 0037 form. This requirement applies to all applicants, regardless of their position, to ensure that no material assistance has been provided to terrorist organizations.

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

Answering “yes” to any question on the Ohio HLS 0037 form indicates that material assistance has been provided to an organization on the U.S. Department of State Terrorist Exclusion List. This disclosure may lead to denial of public employment. It is crucial to answer truthfully, as failure to do so can result in legal consequences.

What constitutes “material support or resources”?

Material support or resources include financial assistance exceeding one hundred dollars, as well as various forms of aid such as lodging, training, weapons, and transportation. However, medicine and religious materials are excluded from this definition.

What are the consequences of failing to disclose material assistance?

Failure to disclose material assistance or providing false statements regarding such assistance is classified as a felony of the fifth degree. This can lead to severe legal repercussions, including criminal charges.

Can I request a review if my public employment application is denied?

Yes, if your application for public employment is denied due to a positive indication of material assistance to a terrorist organization, you can request a review. This request must be sent to the Ohio Department of Public Safety’s Division of Homeland Security, and the necessary forms and instructions can be found on their website.

How should I complete the declaration section of the form?

In the declaration section, you must answer each question by indicating either “yes” or “no.” It is essential to provide truthful responses to the best of your knowledge. Incomplete forms will not be processed, leading to automatic disqualification from public employment.

What is the significance of the certification at the end of the form?

The certification at the end of the Ohio HLS 0037 form requires your signature, confirming that all provided answers are accurate. By signing, you acknowledge your responsibility for the correctness of the information and the potential consequences of failing to disclose material assistance.

Common mistakes

Filling out the Ohio HLS 0037 form can be straightforward, but many people make common mistakes that can lead to complications. Here are four frequent errors to avoid:

  1. Inaccurate Responses: Providing incorrect answers to the questions can lead to serious consequences. Always ensure that your responses are truthful and reflect your knowledge.

  2. Leaving Questions Blank: Failing to answer any question can result in disqualification. It's crucial to respond to every question, even if the answer is "no."

  3. Misunderstanding "Material Support": Some individuals may not fully grasp what constitutes "material support or resources." Familiarize yourself with the definition to avoid unintentional disclosures.

  4. Not Signing the Form: Forgetting to sign the declaration is a common oversight. Remember, your signature certifies that your answers are correct to the best of your knowledge.

By being aware of these mistakes, you can ensure that your form is filled out correctly and avoid unnecessary complications.

Documents used along the form

The Ohio HLS 0037 form is a critical document for public employment, focusing on the declaration of material assistance to terrorist organizations. Along with this form, several other documents may be necessary for a complete application or review process. Below is a list of related forms and documents commonly used.

  • Ohio HLS 0038 Form: This form is used for reporting any changes in personal information or employment status after the initial declaration has been submitted.
  • Background Check Authorization Form: This document grants permission for the employer to conduct a background check, ensuring the applicant has no prior connections to terrorist activities.
  • Employment Application: A standard form that collects personal, educational, and professional history from candidates applying for public employment.
  • Affidavit of Truthfulness: This affidavit certifies that all information provided by the applicant is true and accurate, reinforcing the integrity of the application process.
  • Request for Review Form: If an application is denied based on the HLS 0037 form, this document allows the applicant to formally request a review of the decision.
  • Identity Verification Document: A copy of a government-issued ID or other documents that verify the applicant's identity, required for security clearance.
  • Training Certificate: Proof of completion of any required training related to national security or anti-terrorism protocols, which may be necessary for specific positions.
  • Confidentiality Agreement: A document that ensures the applicant understands the importance of maintaining confidentiality regarding sensitive information related to public safety and security.

These forms and documents play an essential role in the evaluation and hiring process for public employment in Ohio, ensuring compliance with legal standards and maintaining national security. Proper completion and submission of all relevant paperwork are crucial for a successful application.

Similar forms

  • Federal Employment Form (SF-86): This form is used for security clearance applications. Like the Ohio Hls 0037, it requires disclosures about associations with organizations that may pose security risks.
  • Department of Defense (DoD) Security Clearance Application: Similar to the Hls 0037, it assesses an individual's background and associations to ensure national security.
  • Employment Eligibility Verification (Form I-9): This form verifies the identity and employment authorization of individuals. It also requires truthful disclosures about eligibility, akin to the Hls 0037's requirement for honest answers.
  • State Employment Application: Many states require disclosures about affiliations with certain organizations. This parallels the Hls 0037's focus on terrorist organizations.
  • Background Check Authorization Form: Used to authorize background checks, this form often includes questions about associations with criminal or terrorist groups, similar to the Hls 0037.
  • Public Safety Employment Application: This application typically includes questions regarding past criminal activity and affiliations with extremist groups, much like the Hls 0037.
  • FBI Background Check Form: This form collects information to conduct a background check, including associations that may affect security clearance, similar to the Hls 0037.
  • National Security Agency (NSA) Security Clearance Application: This application requires disclosures about affiliations and activities that could pose a risk to national security, similar to the Hls 0037.
  • Volunteer Application for Government Agencies: Volunteers often need to disclose any affiliations with groups that could be seen as a risk, akin to the Hls 0037's focus on terrorist organizations.
  • Contractor Security Clearance Application: Contractors must disclose affiliations and potential risks, mirroring the requirements of the Hls 0037.

Dos and Don'ts

When filling out the Ohio HLS 0037 form, it is essential to follow specific guidelines to ensure accuracy and compliance. Below are five things you should and shouldn't do:

  • Do read the entire form carefully before starting to fill it out.
  • Do provide truthful and complete answers to all questions.
  • Do check for any updates or changes to the form on the Ohio Homeland Security Division website.
  • Do sign and date the form to certify your answers.
  • Do keep a copy of the completed form for your records.
  • Don't leave any questions unanswered; every question must be addressed.
  • Don't provide misleading or false information, as this can lead to severe legal consequences.
  • Don't assume that your answers are confidential; they may be subject to review.
  • Don't submit the form without double-checking for errors or omissions.
  • Don't ignore the instructions provided for submitting the form.

Misconceptions

The Ohio HLS 0037 form is an important document for public employment that requires individuals to declare any material assistance provided to terrorist organizations. However, there are several misconceptions about this form that can lead to confusion. Below is a list of seven common misconceptions along with clarifications.

  • Misconception 1: The form is only for individuals with direct ties to terrorism.
  • This form applies to anyone who may have provided material support, even indirectly. It is essential to answer truthfully regardless of perceived involvement.

  • Misconception 2: Answering "yes" to any question automatically results in criminal charges.
  • A "yes" answer indicates a disclosure of material assistance but does not automatically lead to criminal charges. Each case is evaluated on its specifics.

  • Misconception 3: The form only needs to be filled out by employees in high-security positions.
  • All individuals seeking public employment must complete this form, regardless of their job's security level.

  • Misconception 4: Providing assistance under $100 does not need to be reported.
  • Any material support exceeding $100 must be reported. However, even assistance below this amount may raise concerns depending on the context.

  • Misconception 5: The form is optional for those applying for public employment.
  • Completion of the form is mandatory. Failure to do so will result in automatic disqualification from the application process.

  • Misconception 6: The information provided on the form is confidential and cannot be shared.
  • While the form is treated with sensitivity, it may be subject to review by relevant authorities if necessary.

  • Misconception 7: You can provide false information without consequences.
  • Providing false information is a serious offense. It is classified as a felony of the fifth degree, which carries significant legal repercussions.

Understanding these misconceptions can help individuals navigate the requirements of the Ohio HLS 0037 form more effectively. It is crucial to approach this declaration with honesty and clarity.

Key takeaways

Filling out the Ohio HLS 0037 form is a crucial step for individuals seeking public employment in Ohio. Here are some key takeaways to consider:

  • Purpose of the Form: The Ohio HLS 0037 form is designed to declare whether an individual has provided material assistance to organizations identified on the U.S. Department of State Terrorist Exclusion List.
  • Truthfulness is Essential: It is vital to answer all questions truthfully. Any "yes" answer or failure to answer "no" can indicate that material assistance has been provided.
  • Definition of Material Support: Material support includes financial resources, training, lodging, and other forms of assistance, excluding medicine or religious materials.
  • Consequences of Non-Disclosure: Failing to disclose material assistance or providing false information can lead to serious legal repercussions, including felony charges.
  • Review Process: If public employment is denied due to a positive indication of material assistance, individuals can request a review from the Ohio Department of Public Safety’s Division of Homeland Security.
  • Certification Requirement: The form requires a certification of truthfulness. Incomplete forms will not be processed, leading to automatic disqualification.
  • Contact Information: Individuals must provide accurate personal information, including their name, address, and contact numbers, to ensure proper processing of the form.
  • Resource Availability: Additional resources, including the Terrorist Exclusion List and instructions for filing a review request, can be found on the Ohio Homeland Security Division website.