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Placer County Human Resources Department

Supplemental Questionnaire

Last Name First Name


Correctional Officer - I


Supplemental Questionnaire



Have you been convicted of a crime?

Yes No

(Conviction of a crime is not necessarily a bar to employment.  Each case is considered separately based on job requirements). 

You must disclose convictions, including reckless and drunk driving convictions, even if:

  • It happened a long time ago;
  • It was only a misdemeanor;
  • You didn’t have to go to court (your attorney went for you);
  • You had no jail time or the sentence was only a fine or probation 

You may OMIT:   

  • Minor traffic violations;
  • An arrest or detention that did not result in a conviction (Labor Code section 432.7);
  • An arrest, detention, processing, diversion, supervision, adjudication, or court disposition that occurred while you were subject to the process and jurisdiction of the juvenile court;
  • A conviction that has been judicially dismissed or ordered sealed, expunged, or statutorily eradicated pursuant to law (e.g. juvenile offense records sealed pursuant to Welfare and Institutions Code section 389 and Penal Code sections 851.7 or 1203.45);
  • A non-felony conviction for possession of marijuana that is two or more years old (Labor Code section 432.8).


If YES, please state:  1) date, 2) charge, 3) place, 4) court, and 5) action taken in the space below.

If NO, please enter N/A.


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