Scottish Government - SECTION 1 – ESSENTIAL ... · Web viewI confirm that, to the best of my knowledge, the conviction(s) that I am applying to have disregarded under the provisions

APPLYING FOR A DISREGARD

We understand that wrongful and discriminatory past convictions for certain historical sexual offences may have had long lasting negative effects on your life, on your mental and on your emotional well-being. A decision whether to apply for a disregard may also bring with it memories of the past wrong done to you in being convicted of such an offence.

If you consider you may benefit from emotional support, you may wish to contact the LGBT Helpline Scotland at the contact details below, who can confidentially discuss a range of issues with you to support your emotional wellbeing.

LGBT Helpline: 0300 123 2523 open every Tuesday and Wednesday between 12 - 9pm

Email: [email protected]

APPLICATION FORM

In order to consider your application, there is some information that we will need. This is described as essential information. There is also other information that it would be helpful if it could be provided, but it is ok if you are not able to provide some or all of this information as your application will still be considered. This is described as desirable information.

The information we ask for below in Section 1 is to help the Scottish Ministers to (a) satisfy ourselves as to your identity and (b) find and ingather any data about you that may be held to assist in the determination of your application.

The information may be stored and shared with other relevant organisations (for example the police; the Crown Office and Procurator Fiscal Service; the Scottish Courts and Tribunals Service; or Disclosure Scotland), and prescribed records searched, only as far as necessary to process your application.

SECTION 1 – ESSENTIAL INFORMATION ABOUT YOURSELF

CURRENT FULL NAME

DATE OF BIRTH

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PLACE OF BIRTH TOWN:

COUNTRY:

CURRENT ADDRESS

PREFERRED METHOD OF COMMUNICATION

POST ☐

EMAIL ☐

EMAIL ADDRESS, IF PREFERRED

SECTION 2 – DESIRABLE INFORMATION WHERE KNOWN

Please provide as much of the following information as you can. However, please be re-assured that your application will still be considered even if you are not able to provide some or all of the information requested below.

Were you Convicted of an offence in court? ☐ Issued with a police/procurator fiscal ☐warning?

Issued with a fixed penalty notice? ☐

Other? ☐

If other, please specify details

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Name at time of offence (if different from Section 1)

Address at time of offence (if different from Section 1)

Police force/station that dealt with your offence

force/station: approximate date:

Case Reference Number

Offence(s) you were prosecuted for (or a description of the behaviour prosecuted for, if not known )

Sentence imposed following conviction

Name of Court

Approximate date of court case

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CIRCUMSTANCES OF THE OFFENCE

To allow us to fully assess your application, please provide any details you have as to the circumstances of the offence(s) you were convicted of, for example:

a description of the behaviour or activity that you were arrested/charged/prosecuted for;

how old you were at the time, and the age of any other people who were involved;

how the police became involved;what happened after police involvement e.g. did you require to go to court, or were you offered an alternative by the police or Procurator Fiscal, such as a fine

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SECTION 3 - ADDITIONAL INFORMATION

In addition to the information provided in this form, do you wish to submit any further information in support of your application? For example, copies of any documents you have kept about the case, or statements you wish to provide from any other witnesses at the time

Yes ☐

No ☐

If yes, please list here any separate documents and attach in separate sheet(s)

PROOF OF IDENTITY

To help establish your identity copies of TWO official documents must be sent with your application form. These documents between them must show:

Your current name; Date of birth; and Current address

For example, a photocopy of a driving licence, birth/adoption certificate, passport or any other official document e.g. a utility bill, credit card bill or bank statement, which shows your current name and address. Please note that, for example, two utility bills would not be acceptable as these would not confirm your date of birth.

DECLARATION – To be signed by the applicant*

The information which I have supplied in this application is correct and I am the person to whom it relates.

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I confirm that, to the best of my knowledge, the conviction(s) that I am applying to have disregarded under the provisions of Section 5 of the Historical Sexual Offences (Pardons and Disregards) (Scotland) Act 2018 (“the Act”) does not relate to conduct which continued to be a criminal offence, if occurring in the same circumstances, on the day the Act came into force; being 15 October 2019. I understand that information I provide in support of my application will be checked against police and other official records.

Signature: Date:

Please send completed forms to:

By email: [email protected]

By post: Criminal Law & Practice Team, Area GW.14, St Andrews House, Regent Road, Edinburgh, EH1 3DG.

* If you wish or require a representative to sign the form on your behalf, or you are intending to do so for someone else, please contact us at the details above, or by phoning 0131 244 3491.

Similarly, if you have questions about completing this form, please contact us at the details above.

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