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:
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APPENDIX C. PRE-EMPLOYMENT BOOKLET (KEYSTONE INTELLIGENCE NETWORK, INC.)
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?
27. List any other companies you’ve placed applications with in the past six (6) months:
28. Explain why you desire the position you applied for:
29. If you are hired for this position do you intend it to be long or short term?
Explain:
30. Is there anything you are now concealing about your employment history, or about
anything else you feel is important for us to know? YES
NO
If yes, explain:
INTERVIEWER COMMENTS:
MILITARY HISTORY
31. Have you ever been in the United States Armed Forces? YES
NO
(If “No,” go to next page)
32. Branch:
Inducted:
Discharged:
33. Rank at discharge:
Type of job in military:
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349
34. Other than unit citations, list any awards, medals or honors you received:
35. How many times did you:
a. Receive disciplinary action? (Captain’s Mast, Article 15, Summary Punishment)
b. Get taken into custody by military authorities?
c. Get court martialed?
d. Have your rank reduced?
Explain any answers with a number other than zero:
36. List any unauthorized service equipment you kept when discharged:
37. Is there anything you are now concealing about your military history?
YES
NO
If yes, explain:
INTERVIEWER COMMENTS:
FINANCIAL INFORMATION
38. How much money would it take to pay off all of your outstanding debts? $
How much of this represents your: Mortgage $
Car(s) $
39. How many charge cards do you now have with an outstanding balance?
40. When a credit check is performed, how many debts will it show you are currently
behind on?
41. In the last seven (7) years, how many times have you:
a. Defaulted on a loan or a bill?
b. Had deductions taken from your pay by the government/courts?
c. Declared bankruptcy?
d. Been threatened with a law suit due to a bad debt?
e. Had to appear in court due to a bad debt?
f. Been refused a loan or credit by a bank, store, credit card?
g. Had an overdraft on your checking account?
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APPENDIX C. PRE-EMPLOYMENT BOOKLET (KEYSTONE INTELLIGENCE NETWORK, INC.)
Explain any answers with a number other than zero:
42. Is there anything you are now concealing about your financial information?
YES
NO
If yes, explain:
INTERVIEWER COMMENTS:
DRIVING INFORMATION
43. Do you have a valid driver’s license? YES
NO
#Yrs. driving?
44. State:
Any other states you are licensed in:
45. License Number:
Expiration:
Validation:
46. List any other states you were licensed in:
47. Approximately how many miles have you driven in the past twelve (12) months?
48. Do you own a motor vehicle? YES
NO
Are you insured? YES
NO
List vehicles owned, and insurance company:
49. When we check your driving record for the past seven ( 7) years:
a. How many moving violations will it show you have received?
b. How many parking tickets?
c. How many accidents?
d. How many times have you been denied auto insurance?
e. How many times has your license been suspended/revoked?
f. How many tickets do you currently have unpaid?
Explain any answers with a number other than zero:
Is there anything you are now concealing about your driving information?
YES
NO
If yes, explain:
INTERVIEWER COMMENTS:
APPENDIX C. PRE-EMPLOYMENT BOOKLET (KEYSTONE INTELLIGENCE NETWORK, INC.)
351
GAMBLING
50. Circle the types of gambling activities you have done in the past twelve (12) months.
BASEBALL
PINBALL
BASKETBALL
DICE
FOOTBALL
BILLIARDS
LOTTERY
ROULETTE
HOCKEY
HORSES
POOLS
SLOTS
CARDS
OTHER:
51. In the last twelve months:
What is the most money you have won gambling in any one day? $
What is the largest single bet you have made at any one time? $
What is the most money you lost gambling in any one day? $
What is the grand total of money you have lost/won? $
52. How many gambling debts do you owe right now?
53. Would you gamble more if you had more money?
54. Did you ever:
YES
NO
a. Use money you had set aside to pay a bill with to gamble?
b. Borrow money to gamble with?
c. Get cash from a credit card to gamble with?
d. Bet with bookies?
e. Book horses or numbers yourself?
f. Run a betting pool?
g. Work for a professional gambler/bookmaker?
Explain any “YES” answers:
55. Is there anything you are now concealing about your gambling? YES
NO
If yes, explain:
INTERVIEWER COMMENTS:
SECURITY
56. When we check your criminal record for the past seven (7) years, what will we find?
57. Explain any convictions:
VIOLATION
YEAR
PLACE
OUTCOME
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APPENDIX C. PRE-EMPLOYMENT BOOKLET (KEYSTONE INTELLIGENCE NETWORK, INC.)
58. In the last seven years, how many times were you:
a. Served with a subpoena/summons in a criminal or civil case?
b. Questioned by police as a suspect?
c. The buyer of something you thought was stolen?
d. Been indicted for a violation of the law?
e. Sent to jail?
f. Picked up or stopped for shoplifting?
Explain any answers with a
number other than zero:
59. In your entire life, what is the most serious crime you did that you were smart enough
to get away with?
60. Is there anything you are concealing about your criminal history?
YES
NO
If yes, explain:
INTERVIEWER COMMENTS:
HONESTY
While no employer desires to hire an applicant that has a history of major thefts, they rec-
ognize that almost everyone has stolen something here or there over the course of their life.
It is extremely important you answer each question truthfully.
61. If you had to pay for everything you have ever shoplifted would it be:
Over $100
Under $100.
Explain:
62. If you had to pay for everything you have ever shoplifted, what is the most you would
owe?
$
63. When and what was the last thing?
64. If you had to pay for everything you have taken from all of your jobs would it be:
Over $100
Under $100
Explain:
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353
65. If you had to repay cash you have stolen from all of your jobs, what would you owe in:
Past year: $
Past five years: $
Your lifetime: $
66. What is the most cash you have ever taken from a job in any one day? $
67. What is the most property (merchandise/food/supplies/equipment/etc.) you have
ever stolen from a job in any one day? $
68. If you had to pay for non-cash thefts taken from all of your jobs, what would you owe in:
Past year: $
Past five years: $
Your lifetime: $
69.
a. What do you think should happen to an employee caught stealing?
b. Would you give them a second chance?
70. How much cash would an employee have to be caught stealing before you think they
should be prosecuted?
$1.
$5.
$10.
$25.
$50.
$100.
$500.
71. How much merchandise would an employee have to be caught stealing before you
think they should be prosecuted?
$1.
$5.
$10.
$25.
$50.
$100.
$500.
Explain your choices for questions 70 and 71:
72. Out of a hundred employees, how many do you think steal from their job?
73. How many times have you actually seen a co-worker stealing, or been told by a
co-worker that they were stealing?
If you have, what did you do?
74. If you were to observe a co-worker stealing would you report them?
YES
NO
75. How many times have you reported a co-worker for stealing?
76. How many times have you:
a. Been questioned at a job about something missing?
b. Been asked to leave a job because something was missing?
c. Felt you had a good reason to steal from a job?
d. Had another employee show you how you could steal from a job?
e. Been falsely accused of a theft you did not commit?
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APPENDIX C. PRE-EMPLOYMENT BOOKLET (KEYSTONE INTELLIGENCE NETWORK, INC.)
77. Is there anything you are concealing about your honesty? YES
NO
If yes, explain:
INTERVIEWER COMMENTS:
CASUAL DRUG USE
78. Statistics show that close to ninety percent (90%) of the American population has
experimented with some type of illegal drug during their lifetime. Circle every illegal drug
you have ever experimented with or used casually, even if it was only one time, and
indicate the last time you used it.
Marijuana
Hashish
Barbiturates
Tranquilizers
Opium
LSD
Heroine
Cocaine
Amphetamines
Crack
Peyote
PCP
Speed
Mescaline
Meth
Uppers
Downers
Mushrooms
List any illegal drugs not mentioned:
79. What was the largest quantity of illegal drugs you have ever purchased? What did
you pay?
80. What and when was your last purchase of an illegal drug?
81. What were the most illegal drugs you have ever sold, and what did it sell for?
82. When was the last time you sold an illegal drug?
83. Are you currently using any illegal drugs while working? YES
NO
If yes, explain:
84. Have you ever cultivated or manufactured any illegal drugs? YES
NO
If yes, explain:
85. Is there anything you are concealing about your casual drug use?
YES
NO
If yes, explain:
APPENDIX C. PRE-EMPLOYMENT BOOKLET (KEYSTONE INTELLIGENCE NETWORK, INC.)
355
INTERVIEWER COMMENTS:
I VERIFY THAT ALL OF THE INFORMATION PROVIDED BY ME IN THIS
INTERVIEW/BOOKLET IS TRUTHFUL, AND FULLY UNDERSTAND THAT ANY
DELIBERATE OMISSIONS OR MISINFORMATION MAY RESULT IN MY
REJECTION FOR THIS POSITION.
Applicant Signature
Time
UPON COMPLETION
How do you feel now that you have finished answering the questions in this
interview/booklet?
Should we believe all of your answers were truthful?
Give us one reason why we should believe your answers.
What would you say if the background investigation turns up evidence that proves you
lied about critical information?
What were your emotions while completing this interview/booklet?
Were you afraid?
Thank you for your cooperation.
Remember, you are one of several applicants being considered for this position. After the
backgrounds of all applicants are verified your potential employer will select the most
qualified candidate for the job.
If you filled out this booklet yourself, please turn it in now.
356
APPENDIX C. PRE-EMPLOYMENT BOOKLET (KEYSTONE INTELLIGENCE NETWORK, INC.)
APPENDIX C. PRE-EMPLOYMENT BOOKLET (KEYSTONE INTELLIGENCE NETWORK, INC.)
357
A P P E N D I X
D
Questionnaire
KEYSTONE INTELLIGENCE NETWORK
1704 Locust Street, Second Floor, Philadelphia, PA 19103
(215) 545-1111
Instructions
We would like you to read the following instructions very carefully before you start
answering the questions. We would like you to realize:
1. Every word is important, and each one may be checked later.
2. This is not a draft, and you only have one chance to write down the answers. So,
before you write we would like you to think as to how you are going to phrase your
answers.
3. Please write your answers in as detailed a way as you can to enable us to understand
your case.
4. Use only a pen while writing (no pencils). No typing is allowed.
5. Use clear handwriting to enable reading.
6. You are not to make any corrections on the questionnaire. If you feel that you would
like to change an answer, please do it in the space provided for that purpose,
or
encircle the mistaken sentence and continue on. Your correction will be taken into
consideration.
Effective Interviewing and Interrogation Techniques
359
# 2011, Elsevier Ltd.
360
APPENDIX D. QUESTIONNAIRE
We have reached the conclusion that
.
Write in detail what you know about this and how you would explain it.
(Use Reverse Side if Necessary)
APPENDIX D. QUESTIONNAIRE
361
If you were going to conduct this investigation how would you do it?
362
APPENDIX D. QUESTIONNAIRE
List the five (5) most important causes that would have created this situation.
APPENDIX D. QUESTIONNAIRE
363
Write in detail what happened from the time you woke up, until you went to sleep,
on
.
364
APPENDIX D. QUESTIONNAIRE
It doesn’t mean you are right, and whatever you say is confidential, but, if you had to
suspect someone of doing this, who would you suspect and why?
Who would you least suspect and why?
What do you think should happen to the person who did this when they are caught?
Would you give them a second chance, and why?
Do you think it was deliberate (crime took place), or could it be lost (accidental)?
APPENDIX D. QUESTIONNAIRE
365
Do you know for sure who did this?
Did you do this?
How do you think the investigation will turn out concerning you, and whether or not you
did this?
366
APPENDIX D. QUESTIONNAIRE
Would you like to change any of the answers you provided?
APPENDIX D. QUESTIONNAIRE
367
How do you feel now that you have completed this questionnaire?
Should we believe your answers about whether or not you did this?
If yes, give us one reason why we should believe you.
What would you say if the investigation proved beyond any doubt you did this?
What were your emotions while filling out the questionnaire? How did you feel?
Were you afraid?
If you were asked to pay for
, how much would you be willing to pay?
Please write your name:
Address:
Phone Number:
Index
Note: Page numbers followed by b indicate boxes, f indicate figures and t indicate tables.
“9/11 Commission Report”, 242
involuntary biological signs, 129
operant conditioning, 289 290
A
overview, 283 284
Abdulmutallab, Umar Farouk, 231, 240
preattack warning signs, 294 295
abuse, sexual, 211. See also children, interviewing;
pseudo aggression, 285
NICHD Investigative Interview Protocol
reasons for, 293 294
Academy for Scientific Investigative Training,
Nathan J Gordon, William L Fleisher Page 50