Please complete this form prior to dropping off your stuff (an option for current clients, only), or before arriving for your appointment!
|
Birthdate |
Division/Platoon |
| Name | |
|
| Spouse's Name | ||
| Names of Children | ||
| Home address | ||
| Number of km (average) for round trip home to station | ||
| Home Phone |
Pager |
Cell |
| Court | ||
| Number of off duty appearances | Number of on duty appearances | |
| Paid Duty | ||
| Total number of hours | Total number of paid duties | Total income |
| Automobile Information (if you have more than one vehicle, please answer each question for each vehicle) |
||
|
Vehicle 1 |
Vehicle 2 |
|
| Make/model | ||
| Number of cylinders | ||
| Purchase price | ||
| If Leased, monthly payment |
||
| If Financed, | ||
| Amount | ||
| Date | ||
| Term | ||
| Interest rate | ||
| Loan balance on January 1st, 1999 | ||
| Loan balance on December 31, 1999 | ||
| Repair and maintenace totals for 1999 | ||
| Insurance | ||
| Licence | ||
| Other expenses List any item "required" by regulation to preserve the law that the force will not supply or reimburse you for such as: |
||
| Communication costs (pager, cellphone) and any other relevant info. | ||
|
||
Welcome | Registration | Tax Forms | 1999 Tax Info | Copper Info | Contact