Apply Here - Roman Security Agency

EMPLOYMENT APPLICATION

All information entered on this form is considered to be offered as a sworn statement. Any misstatement of fact is reason for disqualification for employment, or may be punishable by law as per N.J.S. 2C:28-2, 2C:28-3 and 2C:28-7.

No person shall be employed by any holder of security agency license until such person to be employed shall have executed and furnished to such license holder the following statement, pursuant to the provisions of “The Security Officer Registration Act (SORA)” as amended by Chapter 134, Laws of 2004.

Name of Security Agency: ROMAN SECURITY AGENCY, LLC

Address: 561 BLOOMFIELD AVENUE, 2^ND FLOOR, NEWARK, NJ 07107

Date License Issued: AUGUST 28, 2024

Number of License: 1026

a. Name of Employee in Full*
S.S. No.*
b.Residence/Address*
Street Address City State / Province / Region ZIP / Postal Code
c. Home Phone:
Cell Phone:*
Email*
d. Age*
Birth Place*
Birth Date*
S.O.R.A. / Temporary Number
e. Are you a citizen of the United States?*
If not, have you filed your declaration of intention to become a citizen?*
If filed, when and where?*
f. If you are not a citizen of the United States, of what country are you a citizen or subject?
2.Have you ever been convicted of illegally using, carrying, or possessing a pistol or other dangerous weapon?*
3.Have you ever been convicted of unlawful entry of a building?*
If so, give full details:
4. Have you been convicted of a crime of the first, second, third or fourth degree?_*
If so, give full details:
5.Have you ever been indicted for any crime or offense in this State or any other State or Territory?*
If so, give full details:
6. Has any security agency license issued to you or to a partnership or corporation of which you were a member or officer, ever been revoked in this State or any other State or Territory because of conviction of any of the crimes or offenses specified in this section?*
If so, give full details:
7.Have you ever been convicted of any other crime or offense?*
If so, give full details:
8. Has this State or any other State or Territory ever denied any application submitted by you for license as a security officer because of any crime or offenses specified in the preceding questions?*
Reference:
Relationship:
Address:
Years aquainted:
Phone Number:
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Reference:
Relationship:
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Years aquainted:
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