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Locksmith Application, Page 3

Were you transported to or surrendered at a police station, sheriff’s office or other law enforcement facility? Yes No

Once there, were you fingerprinted, photographed and booked into jail?

Yes No

Were misdemeanor or felony charges filed against you? If yes, please list the charges below. (Attach a separate sheet of paper, if necessary.)

Yes No

City

______________________________ State

b.

Date

Charge

c.

d.

Date

Charge

City

State

Date

Charge

City

______________________________ State

e.

Did you appear before the court and enter a plea of guilty, not guilty or no contest?

Yes No

f.

Did the court dismiss the charges against you?

Yes No

If yes, you are required to provide this office with certified court documents showing the disposition of these charges.

g. Have you ever been convicted of a felony offense? (A felony is an offense for which a jail sentence or probation of one

(1) year or more could have been imposed.)

Yes No

h. Have you ever been convicted of an offense which involved fraud or theft?

Yes No

Persons convicted of offenses involving fraud or theft shall not be entitled to licensure as a locksmith, refer to Tenn. Code Ann. § 62-11-111(a)(7).

i.

If you pled guilty or were found guilty, what was the sentence of the court? (Indicate the fine, time in the county jail or penitentiary, deferred sentence, suspended sentence, or period of probation. List the sentence below and provide all final court dispositions with this application.)

Date

Charge

Sentence

Probation Completed Date

Date

Charge

Sentence

Probation Completed Date

Date

Charge

Sentence

Probation Completed Date

j.

Are you currently on a deferred sentence or on probation?

Yes No

k.

Do you currently have charges pending against you?

Yes No

If yes, you are required to provide this office with certified court documents showing the disposition of these charges within thirty (30) days of these charges being resolved by conviction or dismissal, you must also provide your written explanation of the circumstances surrounding the charges and the arresting officer’s report. (Attach a separate sheet of paper, if necessary.)

City and State

______________________________ Arraignment/Court Date

City and State

______________________________ Arraignment/Court Date

Date of Arrest

Charge

Date of Arrest

Charge

Date of Arrest

Charge

City and State

______________________________ Arraignment/Court Date

Have you read the Tennessee statutes pertaining to Locksmiths and the corresponding Administrative Rules and

do you understand your responsibilities?

Yes No

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