STATEMENT OF VALID IDENTITY CHECK
(Registered Disclosure Body No: 20956800000)
Please refer to guidance on completing DBS applications. Any errors or omissions may delay the countersigning of the DBS Application. This Statement must be signed by person who checked the ID evidence.
SECTION 1
Group 1
Group 2a
Group 2b
SECTION 2
Documents seen (refer to Acceptable Documents over page)
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The Applicant
I confirm that I have checked the evidence in accordance with DBS Identification Checking Guideline
(www.gov.uk/dbs), and I am satisfied that (applicant’s name),
is the person who has signed the DBS Application Form in Section(e), and is the person to whom the application refers.
I confirm that in checking the applicant’s identity, I used Route One / Route Two / Route Three (indicate which)
SECTION 3
Applicant’s Role
The job title is (Q.61) ..............................………………………………………………………….
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How will the Applicant have access to children or vulnerable adults?
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I confirm that the ‘workforce’ within which the applicant will be working is (please tick in appropriate box)
Child Workforce
Adult Workforce
Child & Adult Workforce
Other Workforce
I confirm that the applicant seeks a DBS check at the following level
Standard
Enhanced
(please tick in appropriate box)
I confirm that the position to which this application refers is
Paid Employment
Voluntary
(please tick in appropriate box)
This is a new post
Existing post holder
Existing post holder re-check
Declaration: I understand that CRB Wales will not be held liable if the identity of the applicant is subsequently found to
be false. I confirm that I have read and understand the CRB guidance relating to the checking of the applicant’s identity
(at www.gov.uk/dbs).
I confirm that I have checked the Applicant’s answers given in Sections (a), (b) and (c) of the form and that the
information has been verified
Signed ………………………………… Name (Q.58)(please print) ...........................................................
Position in Employing Organisation ..............………………………………………………………......……
Employing Organisation (Q.62) ……………………………………………………………………..…………
FOR OFFICE USE ONLY
CRB Application Form No.
Address
Received in office
Sent to CRB
CRB Disclosure rec’d
Fee paid:
£
Pay-in Slip No:
Postcode
DOB
:
Cheque No:
BACs Date:
Billing statement
Date:
NI Number
Invoice No:
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