of this form.
WITNESS
DATE
(SEAL) Signature of interviewee
DATE
PERSONAL DATA
Age:
DOB:
Married:
Single:
Separated:
Divorced:
Children:
Driver’s license:
Ever arrested? □ YES □ NO
If yes, explain:
When asked to do interview?
By whom?
How far did you go in school? 1 2 3 4 5 6 7 8 9 10 11 12
Did you graduate?
YES
NO
College:
Years attended:
Degree
Military service:
Years:
Type discharge:
MEDICAL DATA
Have you been hospitalized in the last five years?
YES
NO
If yes, explain:
Under the care of a physician at this time?
YES
NO
If yes, explain:
APPENDIX B. WEIGHTED FAINT FORM
335
Taking any medication at this time?
YES
NO
If yes, explain:
Do you have any pain or discomfort at this time?
YES
NO
If yes, explain:
Do you know of any reason you would have difficulty understanding my questions
and answering them coherently?
YES
NO
If yes, explain:
MISCELLANEOUS
How many hours of sleep did you get last night?
Sleep soundly?
YES
NO
If no, explain:
In the past 24 hours have you had any alcohol/used any illegal substances?
YES
NO
If yes, explain:
POSTURE/DEMEANOR (þ1 Truthful / 0 Inconclusive / 1 Deceptive) Score: (þ) (0) ()
If using MITT do it now and issue one overall score: Score: (þ) (0) ()
ELICITED VERBAL RESPONSES (þ1 Truthful / 0 Inconclusive / 1 Deceptive)
1a. Where do you work?
1b. How long have you worked there/here?
2. What do you do?
3. How do you like working there/here?
(Positive answer/no hesitation—adaptors—coding) Score: (þ3) (0)
336
APPENDIX B. WEIGHTED FAINT FORM
4. What is this interview and investigation about?
(Strong language: steal/theft/rape)
Score: (þ2) (2)
5. Why were you selected to be interviewed?
(Includes self as Suspect)
Score: (þ1) (0)
6. How do you feel about being interviewed?
(Positive answer with no hesitation/no adaptors)
Score: (þ2) (0)
7. Please write/tell me in detail what you know about
this and how you would explain it.
(Explains crime with strong language/
proper use of pronouns)
Score: (þ1) (2)
8. If you were the investigator, how would you
conduct the investigation?
Score: (þ1) (0) (1)
9. What are the five most important causes that
would have created this situation?
Score: (þ1) (0) (1)
10. Did you ever think about doing something like this?
(No hesitation—adaptors)
Score: (þ1) (1)
APPENDIX B. WEIGHTED FAINT FORM
337
11. (Comparison) During the first
years of your life did you ever
?
12. Did you
?
Score: (þ1) (0) (1)
13. (Comparison) In your entire life did you ever
?
14. Who would you suspect?
Score: (þ3) (0)
15. Who would you vouch for?
Score: (þ2) (0)
16. When the person who did this is caught, what
do you think should happen to them?
(Strong punishment: fired/prosecution)
Score: (þ2) (1)
17. Would you give them a second chance?
(“No” without any hesitation)
Score: (þ2) (1)
18. We will be doing a thorough investigation.
We will interview everyone and conduct forensic tests.
How do you think the investigation will come out
concerning you, and whether or not you did this?
(Positive answer)
Score: (þ2) (1)
338
APPENDIX B. WEIGHTED FAINT FORM
19. Would there be any reason evidence would
turn up indicating you did this?
(“No,” without any hesitation—hedges)
Score: (þ2) (1)
20. Would you be willing to chip in to pay for
?
Score: (þ3) (1)
21. Did you tell anyone about what happened and that you
had to be interviewed?
22. Why do you think someone would do something like this?
(Negative/condescending/I don’t know)
Score: (þ1) (0)
23. Do you think it was done deliberately, or could it have been accidental?
Score: (þ3) (0)
24. Do you know for sure who did this?
(“No,” with no hesitation or adaptors)
Score: (þ2) (0)
25. In your entire life, did you ever tell a lie to get out of trouble?
26. Did you lie about whether or not you did this?
Score: (þ) (0) ()
APPENDIX B. WEIGHTED FAINT FORM
339
27. If you had been the interviewer, and had three questions to ask to resolve this problem,
what would you have asked?
(Asks a strong relevant question: “Did I do it?”)
Score: (þ1) (0)
28. If we need to speak with you again would you be willing to return?
AFTER-INTERVIEW INTERVIEW
How do you feel now that the interview is over?
Should I believe your answers? (Note: Must answer
“Yes” here to be considered for a þ3)
If yes, give me one reason why.
What would you say if the investigation proves you did this?
What were your emotions during the interview?
Were you afraid?
If you were asked to pay, how much would you be willing to pay?
Score: (þ3) (0)
340
APPENDIX B. WEIGHTED FAINT FORM
NOTE: To receive a þ3, interviewee must answer second question “Yes,” and then say:
“I did not lie,” “I told the truth,” or “I did not do the crime” as part of their answer to
any other question.
TOTAL SCORES FROM ALL PAGES:
DETERMINATION: NDI? DI
A P P E N D I X
C
Pre-employment Booklet (Keystone
Intelligence Network, Inc.)
File No.:
APPLICANT’S NAME:
(First)
(Middle)
(Last)
Company/agency applying with:
Requested by:
Phone No.:
Location of interview:
Interviewer:
Oral report to:
Date:
Time in:
Time out:
Code: MA A LA UA
CONFIDENTIAL
WARNING
This booklet is the property of
KEYSTONE INTELLIGENCE NETWORK, INC.
No part of this booklet may be reproduced without written permission.
Removal of this booklet from this office without permission will result in
; criminal charges for theft by unlawful taking.
#1992
Effective Interviewing and Interrogation Techniques
341
# 2011, Elsevier Ltd.
342
APPENDIX C. PRE-EMPLOYMENT BOOKLET (KEYSTONE INTELLIGENCE NETWORK, INC.)
KEYSTONE INTELLIGENCE NETWORK, INC.
1704 Locust Street
Philadelphia, PA 19103
(215) 545-1111
Fax: (215) 545-1773
INSTRUCTIONS
Please read and sign the “Consent/Release Form” on Page One (1) to allow our investiga-
tive agency to perform your background investigation.
This process is designed to identify one out of ten applicants who have engaged in serious
unacceptable past behavior.
Nine out of ten applicants should do well, but only seven do!
Two of these nine applicants that should do well deliberately withhold, or lie, about infor-
mation that is later uncovered during our investigation.
Usually this information would not have been serious enough to have affected their chance
for employment; however, because they did not tell the truth, it shows either a lack of
integrity or maturity on their part, and they are eliminated from consideration.
Therefore, it is extremely important that you answer every question truthfully. Your back-
ground investigation is only one component of the employment decision. We do not expect
you to be a saint! We do expect you to be truthful!
Remember, this is an employment background form. Clarity and legibility are a reflection of
you. Use only a pen. Do not make any corrections. Think before you write!
CONTENTS
Consent Form 145
Gambling 155
Biographical Information 145
Security 156
Education 147
Honesty 157
Medical and Physical Data 148
Casual Drug Use 159
Employment History 149
Completion Instructions 161
Military History 152
Interviewer Evaluation 161
Financial Information 153
Psychological Assessment 162
Driving Information 154
APPENDIX C. PRE-EMPLOYMENT BOOKLET (KEYSTONE INTELLIGENCE NETWORK, INC.)
343
PRE-EMPLOYMENT CONSENT AND RELEASE FORM
In connection with my application for employment with this potential employer:
I understand that investigative background inquiries are to be made on myself including,
but not limited to, CONSUMER/CREDIT, CRIMINAL, DRIVING, EDUCATIONAL,
EMPLOYMENT, AND OTHER INFORMATION. These reports will include information
as to my character, work habits, performance and experience, along with reasons for termi-
nations of past employment. Furthermore, I understand that you will be requesting infor-
mation from various Federal, State, Local and other agencies which maintain records
concerning my past activities relating to my driving, credit, criminal, civil and other experi-
ences, as well as claims involving me in the files of insurance companies.
I authorize, without reserve, any party or agency contacted by KEYSTONE INTELLI-
GENCE NETWORK, INC., or by this potential employer, to furnish any and all information
they have regarding me.
I further agree to allow an agent of KEYSTONE INTELLIGENCE NETWORK, INC., to per-
form a Pre-employment Security Assessment Interview with me. I understand that falsifica-
tion of any information during this interview may result in my disqualification for the
position for which I am applying for.
I hereby release, remise, waive, and forever discharge all and each of KEYSTONE INTEL-
LIGENCE NETWORK, INC., this potential employer, and any agency, institution, or busi-
ness releasing information, as well as their successors, assigns, agents, servants, officers,
workmen and employees, from any and all actions which I have now, or may ever have
resulting directly or indirectly, or remotely resulting from any information released, the
Pre-employment Security Assessment Interview, any written attitude tests I take, or, from
the written or oral opinions rendered in the course of this investigation.
PRINT FULL NAME:
APPLICANT’S SIGNATURE:
WITNESS:
DATE:
BIOGRAPHICAL INFORMATION
1. Home phone number:
Business phone number:
2. Are you a citizen of the U.S.?
If not, Alien registration #:
3. Have you ever used a name, or alias, that was not registered with the courts?
Yes
No
If yes, list them:
344
APPENDIX C. PRE-EMPLOYMENT BOOKLET (KEYSTONE INTELLIGENCE NETWORK, INC.)
4. Social Security number:
State where it was issued:
RESIDENCY – List all of your addresses during the past ten (10) years. FAILURE TO
LIST ALL OF THEM MAY BE GROUNDS FOR REJECTION. Start with your current
address and work backwards.
Address
From–To
Buying or renting
Number and Street
City, State, Zip Code
Number and Street
City, State, Zip Code
Number and Street
City, State, Zip Code
Number and Street
City, State, Zip Code
5. Position applying for:
6. Full time
Part time
7.
8. Have you ever worked for this organization before?
YES
NO
9. List any friends or relatives that you know are currently employed by this organization:
10. Is there anything you are now concealing about your biographical information, or about
anything else you feel is important for us to know?
YES
NO
If yes, explain:
INTERVIEWER COMMENTS:
APPENDIX C. PRE-EMPLOYMENT BOOKLET (KEYSTONE INTELLIGENCE NETWORK, INC.)
345
EDUCATION
11. Name of school and location
Course
Diploma
GPA
#Credits
High School
College
College
Trade School
Other
12. When your school records are checked, how many times will it show you were
suspended or expelled?
Give details:
13. If High School was not completed, why
14. Are you planning any future educational endeavors?
If yes, explain:
15. List any school sports, clubs or honors:
16. Which subject did you like best in school?
17. Which subject did you like the least?
18. Is there anything you are now concealing about your education, or about anything else
you feel is important for us to know?
YES
NO
If yes, explain:
INTERVIEWER COMMENTS:
MEDICAL AND PHYSICAL DATA
This information is protected under the “Americans With Disabilities Act,” and
questions concerning it are restricted until after an offer of employment is made.
In the event that an offer of employment is made:
19. Are you willing to take a physical examination for this position?
YES
NO
20. Are you willing to take a urinalysis drug screen test?
YES
NO
If yes, cas
ual or experimental illegal drug use will show up for approximately thirty (30)
days. How long would you like to wait before a urine sample is taken?
346
APPENDIX C. PRE-EMPLOYMENT BOOKLET (KEYSTONE INTELLIGENCE NETWORK, INC.)
INTERVIEWER COMMENTS:
EMPLOYMENT HISTORY
A SOCIAL SECURITY CHECK WILL LIST ALL EMPLOYERS.
FAILURE BY YOU TO LIST A PLACE OF EMPLOYMENT
MAY BE GROUNDS FOR REJECTION.
21. Are you currently employed?
YES
NO
22. In the last five (5) years how many:
Full time jobs have you had?
Part time jobs have you had?
23. When we check with all of your past employers, whether they are right or wrong, how
many of them may say you were fired from a job?
List each job and explain what happened:
24. When we check your personnel files for the last twelve months you worked, how many
times will it indicate you were:
Late:
Absent:
Disciplined:
25. How many times at a job have you:
a. Been warned about being absent or late?
b. Been asked to resign?
c. Quit because you thought you would be fired?
d. Had personality problems?
e. Left because of personality problems?
f. Been treated unfairly by an employer?
Explain any answers which have a number other than zero:
APPENDIX C. PRE-EMPLOYMENT BOOKLET (KEYSTONE INTELLIGENCE NETWORK, INC.)
347
26. List all of your places of full time, part time, or temporary employment during the past
ten years. BEGIN WITH YOUR CURRENT OR LAST JOB, AND WORK BACKWARD.
From: Mo.
Yr.
to Mo.
Yr.
Position:
Employer:
Address:
Type business:
Supervisor:
Final Earnings: $
Per:
Salary:
Commission:
Other:
Part time:
Full time:
Liked most about job:
Liked least:
Why did you leave?
Can we contact?
From: Mo.
Yr.
to Mo.
Yr.
Position:
Employer:
Address:
Type business:
Supervisor:
Final Earnings: $
Per:
Salary:
Commission:
Other:
Part time:
Full time:
Liked most about job:
Liked least:
Why did you leave?
Can we contact?
From: Mo.
Yr.
to Mo.
Yr.
Position:
Employer:
Address:
Type business:
Supervisor:
Final Earnings: $
Per:
Salary:
Commission:
Other:
Nathan J Gordon, William L Fleisher Page 49