016.15.06 Ark. Code R. 004

Current through Register Vol. 49, No. 10, October, 2024

Rule 016.15.06-004 - CFS-593: State Vehicle Safety Program - Additional Requirements for DCFS Drivers

CFS-593

Arkansas State Vehicle Safety Program Additional Requirements for DCFS Drivers

PURPOSE

The CFS-593 is used to certify that all persons affiliated with DCFS have read and understand the additional requirements for their mandatory participation in the Arkansas State Vehicle Safety Program (ASVSP).

INSTRUCTIONS FOR THE CFS-593

A. The form must be completed and certified:

1. Job applicants will complete this form AND the Hiring Official will certify it before the person may be selected for a position within the Division.

2. DCFS employees will complete this form AND their supervisor or the supervisor's designee will certify it.

3. DCFS affiliates will complete this form AND the organizational staff member assisting the affiliate will certify it.

B. The DCFS employee or job applicant or DCFS affiliate, who fills out the form, will:

1. Read all eight of the numbered items on page 1 and sign his or her INITIALS to the left of each item, indicating that he or she has read and understands each item;

2. Check only one box to indicate if he or she is a DCFS Employee, or Job Applicant, or DCFS Affiliate;

3. Print his or her name and sign and date the form.

C. The Hiring Official or Supervisor/Supervisor's Designee or Program Manager will:

1. Check one box under "Certification Statement" indicating, which one they are;

2. Print his or her name and sign and date the form.

Routing

A. Send the original, completed form with the packet of documents being prepared (i.e. hire packet).

B. Send a copy to the DCFS Vehicle Safety Program Manager, Slot S561 or Fax a copy to (501) 683-5421.

C. Give a copy to the DCFS Employee or Job Applicant or DCFS Affiliate.

016.15.06 Ark. Code R. 004

12/8/2006