Application Form for Information on Officials Prior to Appointment/Promotion/Election to High Positions/Vetting Process

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Note: Please fill in the requested information below carefully and clearly. 

If you have any questions, please contact:
E-mail: info@autoritetidosjeve.gov.al

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SECTION A: INFORMATION ABOUT THE APPLICANT
SECTION B: SPECIFIC INFORMATION ABOUT THE APPLICATION
SECTION C: ADDITIONAL INFORMATION FOR DATA SUPPORTING DOCUMENT IDENTIFICATION ARCHIVE
place of residence/work after reaching the age of 18 (before July 2, 1991)
SECTION C: SUBMITTED DOCUMENTATION
Documents
Note: This form is to be completed and signed by the applicant, and the requesting institution shall submit it to the Authority for Information on the Documents of the former State Security.

I declare that the information provided by me in this document is true and that I have not declared anything that is untrue.

    SECTION A: INFORMATION ABOUT THE APPLICANT

    1. Name
    2. Surname
    3. Emra të tjerë Nëse ka
    3. Mbiemra të tjerë (Para 02/07/1991) Nëse ka
    4. NID Nr. i identifikimit personal
    5. Gender
    6. Emri i babait
    7. Father's surname
    8. Mother's Name
    9. Mbiemri i nënës Para martese
    10. Date of Birth
    11. Place of Birth
    12. Nationality
    13. Shtetësi të tjera Nëse ka
    14. Address
    15. City
    16. District
    17. Postal Code
    18. E-mail
    19. Phone Number
    20. Landline Phone Number

    SECTION B: SPECIFIC INFORMATION ABOUT THE APPLICATION

    Current position
    22. Position for which the candidate is applying
    If applicable
    23. Entity in which the candidate is applying
    If applicable
    24. Reason for verification

    SEKSIONI C: INFORMACION SHTESË PËR TË DHËNA NDIHMËSE PËR IDENTIFIKIMIN E DOKUMENTACIONIT ARKIVOR - vendi i banimit/punës pas mbushjes së moshës 18 vjec (para 2 korrikut 1991)

    From date dd/mm/yyyy
    On date dd/mm/yyyy
    Name of the Center / Institution where employed and the school where studied
    District / City / Area / Unit / Border Post
    Position held
    Have you previously applied for background verification?
    SECTION D: SUBMITTED DOCUMENTATION
    Photocopy of identity card.
    Notarized copy of the name change decision, if there are other names (as filled in point 3).
    Justification from the Subject for priority processing of the request.
    Note: This form is to be completed and signed by the applicant, and the requesting institution shall submit it to the Authority for Information on the Documents of the former State Security.
    Applicant's Signature
    Date of Signature
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