An example of filling out a questionnaire for a device in the Ministry of Internal Affairs. Sample filling out a questionnaire in the FSB
SAMPLE
FILLING IN THE APPLICATION
ON ADMISSION
PUBLIC CIVIL SERVICE
Note: the questionnaire is filled in by hand only.
APPROVED BY
by order of the Government
Russian Federation
from 01.01.01
(as amended on 01.01.01)
A N K E T A
(filled in with your own hand)
|
1. Surname | Chernenko |
Ivan |
|
middle name | Ivanovich |
2. If you changed the last name, first name or patronymic, then indicate them, as well as when, where and for what reason they changed | Surname, name or patronymic did not change (a) |
other options (when changing the surname) | Changed the name of Nikolaev to Vlasova, 05/22/1978, the city of Oryol, in connection with the conclusion of marriage, certificate of the Ministry of JusticeII No. 000 |
Changed the name of Vlasov to Nikolaev, 09/12/1984, Dmitrov, Moscow region, in connection with divorce, certificate MU-I No. 000 |
P note : entries are made on the basis of a marriage certificate, divorce certificate or a certificate of change of surname (name, patronymic).
3. Date, month, year and place of birth (village, village, city, district, region, region, republic, country) |
village Stepanovo, Domodedovsky district, Moscow region |
other options |
moscow city |
German Democratic Republic |
|
May 5, 1962 Stanitsa Konstantinovskaya, Krasnodar Territory |
P note : as recorded on the birth certificate or in the passport.
5. Education (when and what educational institutions they graduated from, diploma numbers) Direction of training or diploma specialties. Diploma qualification | Higher professional, 1980 year., Yaroslavl Higher Financial School named after General of the Army, diploma ЗВ № financial support and control of financial and economic activities, officer with higher military special education - economist-financier 1997 year., Military Finance Academy, Moscow, diploma with honors VF № finance and military economics, officer with higher military financial and economic education |
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other options | Secondary vocational, When filling out this item, it is necessary to name the organizations as they were called at one time, record military service with an indication of the position and number of the military unit.
P note : positions and organizations are indicated without abbreviations; until 1999, the address of the organization is indicated without the street and house, and since 2000, the full address is indicated. |
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The preparation of materials for citizens, issued (reissued) for admission to special importance, top secret and secret information, is carried out by the departments (departments) of personnel, and in their absence - by employees conducting personnel work in the organization (hereinafter referred to as personnel). It is prohibited to send citizens to the divisions for the protection of state secrets and security agencies on issues of registration of admission.
Citizens who are registered for admission to state secrets fill out a questionnaire (form 2), in which they are required to indicate reliable data.
Employees of the personnel apparatus during a conversation with a citizen applying for work (service) verify the data specified in the questionnaire with his personal documents (passport, military ID, work book, educational diploma, birth certificate, etc.), clarify certain questions of the questionnaire , identify information of interest that is not provided for in the questionnaire, find out from the citizen whether over the past year he had anything to do with secret works, documents and products, whether he gave an obligation to not disclose information constituting a state secret, whether he worked (served) in sensitive facilities , request the necessary certificates and documents, acquaint the citizen with the content of the agreement (contract) on registration of admission to state secrets (form 9).
If, in the course of the conversation or in the personal data, circumstances are revealed that affect the decision to admit a citizen to state secrets, or it is established that he previously worked with special importance or top secret information, then employees of the personnel department are obliged to inform about the results of the conversation in oral or written the form of the head of the department for the protection of state secrets of the relevant organization.
The conclusion of an agreement (contract) on registration of admission to state secrets is carried out in compliance with all the requirements of the civil and labor legislation of the Russian Federation.
The application form of a citizen issued for admission is signed by an employee of the personnel department and certified by a seal.
Subdivisions for the protection of state secrets:
- develop recommendations for personnel on registration of citizens to work, subject to admission;
- request, if necessary, from the departments for the protection of state secrets of the organizations where the registered citizen worked during the last year, a card (form 3);
- assess the primary materials submitted by the personnel staff for the registered (reissued) citizens or received from the divisions for the protection of state secrets from the previous places of work of these citizens, in order to determine the feasibility of conducting verification measures by the security authorities;
- prepare and store registration materials for admission: cards (forms 3 and 8) and lists of persons subject to admission to classified information (form 6);
- exercise control over the fulfillment of admission requirements.
Required documents
For each citizen who is issued for admission on the first or second form, the staff submits to the department for the protection of state secrets, and the department for the protection of state secrets sends the following documents to the security body:
a) a motivated letter on the need to issue an admission to state secrets. The letter indicates the position for which the citizen is registered, and its serial number in the approved nomenclature of positions, the number of persons admitted in this position to information constituting a state secret, the number of the citizen's previous admission, the date of completion of the verification activities and the name of the security body, who conducted them (in the case of re-issuance of admission - the reason for re-issuance), the circumstances influencing the decision on admission are noted and an assessment is given to them;
b) questionnaire (form 2);
c) 1 copy of the card (form 3) registered in the register of cards for the admission of workers according to the first and second forms (form 10);
d) by agreement with the security body 1 or 2 copies of the registration card for admission according to the first and second forms (form 5). In the event that a citizen issued for admission to special importance or top secret information permanently resides not in the location of the organization, but in another region of the Russian Federation (republic, territory, region), an additional copy of the registration card is sent to the security body (Form 5) ;
e) in agreement with the security body, 2 or 3 copies of the list for the citizen being drawn up and his close relatives (father, mother, brothers, sisters and children over 16 years old), as well as for the wife (husband), including the former (form 4) ... In this case, a separate list is drawn up for each surname.
Motivated letters on the need to issue admission to state secrets and cards (forms 3 and 5) are prepared by the division for the protection of state secrets.
Sample application form for admission to state secrets
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We issue admission to state secrets
Earlier, we determined what kind of admission to state secrets is, what duties, as well as additional guarantees, employees who have received such admission have *. Today we will talk about the paperwork at the stage of granting a citizen access to information constituting a state secret, and about the role of personnel service employees in the admission procedure.
According to Art. 21 of the Law of the Russian Federation of July 21, 1993 No. 5485-1 "On State Secrets" (hereinafter - the Law on State Secrets), the procedure for admitting employees to state secrets provides for:
1) Acceptance of obligations to the state on the non-proliferation of information entrusted to them, constituting a state secret;
2) Consent to partial, temporary restrictions on their rights in accordance with Art. 24 of the Law on State Secrets;
3) Written consent to conduct verification activities in respect of them by the authorized bodies;
4) Determination of the types, sizes and procedure for the provision of social guarantees provided for by the Law on State Secrets;
5) Familiarization with the norms of the legislation of the Russian Federation on state secrets, which provide for liability for its violation;
6) Adoption of a decision by the head of a public authority, enterprise, institution or organization on the admission of a registered person to information constituting a state secret.
NA No. 5'2010The procedure for admitting state secrets is regulated in detail by instructions on the procedure for admitting officials and citizens of the Russian Federation to state secrets, approved. Resolution of the Government of the Russian Federation dated 06.02.2010 No. 63 (hereinafter referred to as the Instruction). The admission procedure includes a number of stages. Let's consider them in more detail.
Stage 1 Submission of documents
In accordance with Part 2 of Art. 65 of the Labor Code of the Russian Federation in some cases, taking into account the specifics of the work of the Labor Code of the Russian Federation, other federal laws, decrees of the President of the Russian Federation and decrees of the Government of the Russian Federation may provide for the need to present additional documents when concluding an employment contract. The Law on State Secrets does not provide for the list of documents required for registration of admission.
According to clause 28 of the instructions, an applicant for access to state secrets is obliged to submit:
1. A self-filled questionnaire ( attachment 1). The questionnaire must be signed by an employee of the personnel department and certified by the seal of the organization or personnel department.
The information provided in the questionnaire includes:
a) information about the applicant for admission himself;
b) information about close relatives;
c) a mark on familiarization with the legislation on state secrets, consent to verification activities.
What information about close relatives is indicated in the questionnaire?
In the Instructions, close relatives mean a wife / husband, children, adoptive parents, adopted children, full blood brothers and sisters (having a common father or mother). If close relatives change their surname, first name or patronymic, the previous surname, first name or patronymic is also indicated in the questionnaire. The questionnaire contains information about the residence of close relatives abroad and the periods of such residence. In paragraph 3 of the questionnaire, the question is raised about the convictions of close relatives, indicating the time and grounds of the conviction, although the presence of a criminal record of close relatives is not a reason for refusing admission.
The questionnaire indicates that the applicant is familiar with the legislation on state secrets and the responsibility for its violation. Also, the applicant is notified of the negative legal consequences for the presentation of deliberately false data in the questionnaire.
For making a decision on the refusal of admission to state secrets, it is the very fact of being on trial or investigation for the designated types of crimes that matters, and not the existence of proof of guilt and a conviction by the court.
According to Art. 86 of the Criminal Code of the Russian Federation, a person convicted of a crime is considered to be convicted from the date the court's conviction comes into legal force and until the moment the conviction is canceled or canceled. In accordance with Art. 400 of the Code of Criminal Procedure of the Russian Federation, the conviction is removed by the court on the basis of the petition of the person who served the sentence before the expiration of the term for the cancellation of the conviction.
Grounds 2. The presence of medical contraindications for work with the use of information constituting a state secret, according to the list approved by the federal executive body authorized in the field of health care and social development.
Grounds 3. Permanent residence of him and (or) his close relatives abroad and (or) execution of documents by the specified persons for leaving for permanent residence in other states.
According to the Instruction, permanent residence abroad is understood as the residence of citizens outside the Russian Federation for more than six months during the year, not related to the performance of their civil service duties.
Basis 4. Revealing, as a result of verification measures, actions of the person being formalized that pose a threat to the security of the Russian Federation.
The law on state secrets does not define actions that pose a threat to the security of Russia. For comparison, in accordance with Federal Law No. 115-FZ of 25.07.2002 "On the Legal Status of Foreign Citizens in the Russian Federation", actions that pose a threat to security include a violent change in the foundations of the constitutional order of the Russian Federation. The question of the threat to security created by the actions of the person being registered is decided in each case by the security authorities.
Grounds 5. Evasion of the formalized person from verification activities and (or) informing them of knowingly false personal data.
The decision to deny an official or citizen access to state secrets is made by the head of a public authority, enterprise, institution or organization on an individual basis, taking into account the results of verification activities. A citizen has the right to appeal this decision to a higher organization or to a court.
In the next issues of the "Handbook of a Personnel Officer" we will talk about the peculiarities of remuneration of employees who have access to information constituting a state secret, as well as the consequences of terminating access to state secrets.
Form of the questionnaire drawn up upon receipt of admission to state secrets
Form of a certificate of the absence of medical contraindications for work using information constituting a state secret
The approximate obligation of a citizen to comply with the requirements of the legislation on state secrets
Magazine: Handbook of a personnel officer, As of: 04/07/2013, Year: 2013, Number: No. 5
Only authorized registered users have the ability to add publications.
No one has commented on this article yet, if not you, then who will leave a review or advice? It is prohibited to send people to the protection units of the state secret and security authorities on issues of admission design. Have you been convicted, when and for what (to be completed when entering the municipal civil service) 10.
You can download a ready-made example of a questionnaire free of charge and save it so as not to lose it. What foreign languages \u200b\u200band languages \u200b\u200bof the peoples of the Russian Federation do you speak and to what extent (read and translate with a dictionary, read and be able to explain, speak fluently) 8. The admission to state secrets was formalized in the Ministry of Internal Affairs of the Russian Federation in 1993.
Sample of filling out the questionnaire form 4
Have you previously received admission to state secrets (in what standard of filling the questionnaire for state secrets, the note is filled in with your own hands.
Sample filling out the questionnaire 148 kb - ministry
Citizenship (if changed, then indicate when and for what reason, if you have the humanity of another. Target letters about the need for the design of admission to state secrets and cards (forms 3 and 5) are prepared by the department for the protection of state secrets. as they were called at one time, record military service with an indication of the position and number of the military unit.
Form 4 - recrut mil ru
The conclusion of an agreement (agreement) on registration of admission to state secrets is carried out in compliance with all the requirements of civil and labor legislation of the Russian Federation. Access to state secrets, issued for the period of work, service, study, its form, number and date (if any). Have you previously received access to state secrets (in what.).
If relatives changed their family name, name, patronymic, you must also indicate their previous family name, name, patronymic. Date, month, year and place of birth (village, village, city, district, region, region, republic, country) 4. The questionnaire for voluntary resettlement in the Russian Federation of people living abroad is business-simple.
Admission to state secrets, issued for the period of work, service, study, its form, number and date (if any) 11. Copying the page of the questionnaire for admission to state secrets, rewriting one hundred percent or in part - is welcome, only with an active link to the source. Work performed from the beginning of labor activity (including study in higher and secondary special educational institutions, military service, part-time work, entrepreneurial activity, etc. Admission to state secrets, issued during the period of work.).
When filling out the questionnaire:
1) fill in all its columns with your own hand, in a neat and legible handwriting,
2) give full answers to all questions, in strict accordance with the records contained in your personal documents,
3) do not allow abbreviations of names, corrections or deletions, dashes, blots,
4) in the absence of information or negative answers to the questions asked in the questionnaire, do not put a "dash" sign and do not leave the columns empty, you should indicate: "I do not have", "I do not know", etc.,
1. When filling out the section "Education" the following wording should be used: "basic general", "secondary vocational", "higher", depending on what document you have. The names of educational institutions, specialties and qualifications should be written in strict accordance with the existing documents without their abbreviation.
2. In the section "Work performed from the beginning of labor activity" information about work is reflected in strict accordance with the entries in the work book (without abbreviations), including studies in higher and secondary specialized institutions, military service, part-time work, entrepreneurial activity. All entries are made in chronological order.
3. In the section "Your close relatives" all family members are listed with an indication of the degree of kinship (father, mother, brother, sister, son, daughter, husband, wife, including former ones) and if the surname, name, patronymic is changed, their previous surname, name, patronymic are indicated in brackets. At the end of the table, the entry “I have no other close relatives” is made.
4. When filling out the section "Additional information" it is desirable to indicate other professional skills: the degree of proficiency in a PC, software (indicating the names of specific programs), etc.
5. After completing the questionnaire, carefully check the information you provided and make sure that all fields are filled in in accordance with these recommendations and the sample questionnaire.
A questionnaire without a photo is not considered.
If you fill out the questionnaire not in accordance with these recommendations and the sample questionnaire, you may be denied acceptance of documents.
APPROVED BY
by order of the Government
Russian Federation
dated 01.01.01 N 667-r
SAMPLE QUESTIONNAIRE
photos |
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1. Surname | |||
middle name | Ivanovna | ||
2. If you changed your surname, first name or middle name, then indicate them, and when, where and for what reason changed | She changed her surname to Ivanova on May 24, 1982 in the registry office of the Central District of Moscow due to her marriage. |
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3. Day, month, year and place birth (village, village, city, district, region, edge, republic, | ||||
4. Citizenship (if changed, then indicate when and for what reason if you have citizenship other state - specify) | Russian citizen. |
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5. Education (when and what graduated from educational institutions, diploma numbers) Direction of training or diploma specialty Diploma qualification | 1) Specialized secondary: in 1980 she graduated from the Polytechnic named after , diploma, specialty Analytical chemistry, qualification of a technician-chemist. 2) Higher: in 1988 she graduated from Moscow, diploma, specialty Jurisprudence, qualification of a lawyer. |
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postgraduate studies, postgraduate studies, doctoral studies (name of the educational or scientific institution, year ending) Academic degree, academic title (when assigned, numbers diplomas, certificates) | I have no postgraduate professional education, an academic degree, an academic title. |
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languages \u200b\u200bof the peoples of the Russian Do you own federations and in which degrees (read and translate from dictionary, read and can explain yourself fluently) |
diplomatic rank, military or special title, cool rank of law enforcement, class rank of the civil service subject of the Russian Federation, qualifying rank public service (by whom and when assigned) | The class rank of the secretary of the state civil service of the Chita region of the 2nd class was awarded by the head of the Department for ensuring the activities of justices of the peace of the Chita region on August 1, 2003. |
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9. Have you been convicted (when and for what) | Not convicted. |
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10. Admission to the state secret, issued for the period work, service, study, its form, number and date (if available) | She had access to state secrets, issued during the period of work at the Institute of Biophysics of the USSR Ministry of Health of the second form since July 1983. |
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11. Work performed from the beginning of labor activity (including study in higher and secondary specialized educational institutions, military service, part-time work, entrepreneurial activity, etc.). When filling out this item, it is necessary to name the organizations as they were called at one time, record military service with an indication of the position and number of the military unit. |
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Position with indication organization | Organization address (including abroad) |
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receipts | ||||
Student of the Polytechnic named after | ||||
Interrogator of the Moscow City Department of Internal Affairs | ||||
Researcher, Institute of Biophysics, Ministry of Health | ||||
moscow, pl. Miusskaya, 6 |
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Secretary of the Court Session of the Office for Ensuring the Activities of Justices of the Peace of the Chita Region | ||||
until now | Head of HR department | chita, ave. Soviets, 20 |
||
Concurrently a lawyer of the State Enterprise "BAT" | ||||
12. State awards, other awards and distinctions_ I have no state awards. In 1999, she was awarded the departmental distinction "Excellence in Health Care"________________________________________________________________ 13. Your close relatives (father, mother, brothers, sisters and children), as well as your husband (wife), including former ones. |
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If relatives changed their last name, first name, patronymic, you must also indicate their previous last name, first name, patronymic. |
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patronymic |
birth | Place of work (name organizations), position | Home address registration, actual residence) |
|
Viktorovich | He died in 1978. | Buried in the village of Kazanskaya, Verkhnedonsky district of the Rostov region |
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Golubeva (Petrova) Marina Dmitrievna |
The village of Kazanskaya, Rostov region | pensioner |
st. Lenin, 2 |
|
Viktorova (Golubeva) Ivanovna |
The village of Kazanskaya, Rostov region | Accountant Sovkhoz Donskoy, Stanitsa Kazanskaya, Rostov region, st. Sovetskaya, 6 | The village of Kazanskaya, Verkhnedonsky district of the Rostov region, st. Lenin, 2 |
|
Viktorovich |
moscow city | Electrician, Stanitsa Kazanskaya, Verkhnedonsky district of Rostov region, Vashutinskoe sh., 1 | The village of Kazanskaya, Verkhnedonsky district of the Rostov region, |
|
Sergeyevich |
moscow city | Warehouse Manager State Enterprise "BAT" | ||
Ex-husband |
Olegovych |
moscow city | The marriage was dissolved in 1985. | I have no information about my ex-husband, I do not keep in touch with him. |
close relative | i don’t have. | |||
14. Your close relatives (father, mother, brothers, sisters and children), as well as your husband (wife), including the former, permanently residing abroad and (or) drawing up documents for leaving for permanent residence in another state |
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Close relatives permanently residing abroad and preparing documents for____ I do not have departure for permanent residence in another state.______________________ |
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(surname, name, patronymic, since when they have been living abroad) |
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15. Stay abroad (when, where, for what purpose) |
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In 2003 she was in France for tourist vouchers, in 2004 in Italy, in 2006 in Portugal, China. |
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16. Attitude towards military service and military rank not liable for military service.__________ |
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17. Home address (registration address, actual residence), phone number (or other type of communication) |
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i live at the same address. Phones: home. , slave. , mob. 43-3333. |
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18. Passport or document replacing it |
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19. Having a foreign passport i do not have______________________________________ |
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(series, number, by whom and when issued) |
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20. Number of insurance certificate of compulsory pension insurance (if any) -19 ________________________________________________________ |
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21. TIN (if any) ____________________________________________ |
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22. Additional information (participation in elected representative bodies, other |
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information you wish to provide about yourself) I have no additional information._______ |
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23. I am aware that deliberately false information provided about myself in the questionnaire, and my non-compliance with the qualification requirements may result in refusal to participate in the competition and recruitment for the position. |
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I agree to carry out verification measures against me.
Involvement of an employee in performing functions involving work with classified information is impossible without issuing an admission to the state secret for him (justification - government Decree of 06.02.2010 No. 63). The decision on the admission or non-admission of an individual to the information constituting a state secret is made, inter alia, on the basis of a questionnaire form 4. A sample of filling out this form is regulated by the specified Resolution No. 63. An example of a questionnaire is at the end of this article.
Rules of admission to classified information
The term state secret denotes a set of information to which access to legal entities and individuals is limited in order to ensure the security of the country.
Relevant data may be disclosed (Article 2 of the Law of 21.07.1993, No. 5485-1):
- features of the development of military infrastructure;
- conducting foreign policy;
- the results of intelligence and operational-search activities.
Registration of admission to familiarization with classified information and its processing is carried out at the place of employment of officials.
If there is a selection of candidates for a position, the fulfillment of duties for which involves working with a state secret, it is necessary to take into account the criteria for admitting individuals to this type of information. So, hiring is carried out on the condition that a completed and signed by the applicant questionnaire for state secrets of Form 4 is attached to the standard set of documents, the sample of which complies with legislative requirements.
Specificity of the questionnaire
The peculiarities of filling out a questionnaire for the secrecy of Form 4 (for a sample of filling, see below) are as follows:
- the document is filled in by hand;
- responsibility for the data reflected in the form is borne by the person who applies for admission to the state secret;
- a photograph must be pasted in (the size of the photo is 4 × 6 cm).
The completed questionnaire is checked by the security service and endorsed by a personnel worker.
Questionnaire (form 4): sample filling
If the nature of the official (special, functional) duties performed by a person provides for access to information constituting a state secret, a citizen can be appointed to such a position only after obtaining admission to the state secret (clause 6 of the Instruction
State secrets are information protected by the state in the field of its military, foreign policy, economic, intelligence, counterintelligence and operational-search activities, the spread of which may harm the security of the Russian Federation (Article 2 of the Law of the Russian Federation of July 21, 1993 No. 5485-1).
Despite the fact that the admission of officials and citizens of the Russian Federation to the state secret is carried out on a voluntary basis, it will not work to get a job with the state secret without the appropriate admission. Citizens are issued admission to the state secret at their place of work (clause 5 of the Instruction, approved by the Government Decree of 06.02.2010 No. 63).
Citizens who are granted admission to the state secret must submit a self-filled questionnaire in form 4 and attach the necessary documents to it (clause 28 of the Instruction, approved by Government Decree No. 63 of 06.02.2010).
Form 4: form and sample filling
Form 4, filled in at registration of admission to the state secret, is called "Questionnaire". The questionnaire form is attached to the Instruction, approved. Government Decree of 06.02.2010 No. 63.
You can download Form 4 in Word.
As we noted above, the questionnaire is filled out by a person independently by hand. A photograph of 4x6 cm is glued to the questionnaire.
The questionnaire must be completed no earlier than a month before it is sent to the security authority (
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