About Personal Safety And Security

Original Language Title: o personální bezpečnosti a o bezpečnostní způsobilosti

Read the untranslated law here: https://portal.gov.cz/app/zakony/download?idBiblio=75458&nr=363~2F2011~20Sb.&ft=txt

363/2011 Sb.



DECREE



of 23 December 2003. November 2011



about personal safety and security



415/2013: Sb.



The national security agency, establishes, pursuant to § 7 para. 3, § 9 para. 8, § 64,

§ 85 para. 5 and section 135 (a). a) to (f)), and (h)) to) Act No. 412/2005 Coll.

on the protection of classified information and the security of the eligibility, as amended by

amended, (hereinafter referred to as the "Act"):



§ 1



Patterns in the area of staff security and safety



(1) the model Declaration of the natural person pursuant to section 7 of the incapacitation the law is

listed in annex 1 to this notice.



(2) the model declaration relating to personal competence pursuant to section 13 of the Act is

listed in annex 2 to this Decree.



(3) the model Declaration of waiver of confidentiality pursuant to § 94

paragraph. 2 (a). (g)) and § 99 paragraph 2. 2 (a). (d)) of the Act is provided in annex No.

13 of this Decree.



§ 2



Patterns in the area of staff security



(1) the notice of compliance with conditions for access to classified information

classification of Reserved under section 6 of the Act is given in annex 3 to the

This Decree.



(2) the model lessons according to § 9 para. 1 and section 11 (1) 2 of the Act is set out in

Annex No 4 to this notice.



(3) the model of the application of a natural person pursuant to § 94 paragraph. 1 of the Act is set out in

Annex No. 5 to this Decree.



(4) the model questionnaire of the natural person pursuant to section 95 of the Act is given in annex

No. 6 to this Ordinance.



(5) the model of a natural person pursuant to § 54 para. 2 of the Act is set out in

Appendix 7 to this Decree.



(6) the model application for issue of a certificate of a natural person for a foreign power pursuant to §

paragraph 57. 2 of the Act is given in annex 8 to this Ordinance.



(7) the model application for recognition of the security permissions of the natural persons referred to in

§ 62 para. 2 of the Act is set out in annex 9 to this Decree.



(8) the model lessons according to § 58 para. 5 of the Act is provided in annex No 10 to

This Decree.



§ 3



Patterns in the field of security eligibility



(1) the model document requests under § 99 paragraph 2. 1 of the Act is given in annex

# 11 of this Decree.



(2) the model questionnaire pursuant to section 100 of the Act is set out in annex 6 to this

the Decree.



(3) the form of the document about the safety of natural persons according to § 85

the Act is given in annex 12 to this Decree.



§ 4



Justification natural persons according to § 94 paragraph. 1 of the law



Justification natural persons includes putting



and) function or activity within or leaving the

employment, the Member or the like relation, which has

be natural person certificate issued,



(b)) the Supreme classification classified information, which will have

natural person access,



(c) justification for the confirmation) requiring access to classified information

the responsible person, the safety Director or whoever will be the physical

person to provide classified information, including indications of a particular

places or features provided for pursuant to § 69 para. 1 (b). (b)) of the Act, and

the inclusion of this place or function in this overview,



d) specifications for classified information on a given site or function

have already been granted or arose, and classified information here

will be provided or can arise.



§ 5



Justification for the request of proof under § 99 paragraph 2. 1 of the law



Grounds for the application for the document includes putting



and the sensitive activity) has a natural person on the basis of the issued

document exercise,



(b)) the provisions of any other law, pursuant to which it will be exercised

sensitive activity,



(c) justification of performance sensitive) confirmation of the activities of the responsible person or

her legacy by a person, including a description of a place or feature

related to the performance of sensitive activities.



§ 6



A document pursuant to § 94 paragraph. 2 (a). (b)) of the Act to accompany a request

natural persons and documents pursuant to § 99 paragraph 2. 2 (a). (c)) of the Act

supporting the application of document



(1) a natural person to a natural person or to request an application for the document

be accompanied by a



birth certificate or baptismal) list, or other similar documents,



(b) proof of the highest) education,



(c) the employer's confirmation of income), indicating their amount after

deduction of compulsory statutory levies, income in the event of a different kind

tax return or any other document confirming the income for

the last 5 years,



(d) proof of the law of the sea) other person's restrictive ownership of the applicant, and



(e) the decision of the competent authority) regulation enforcement.



(2) the documents referred to in paragraph 1 (b). (b)), and (c)) of the natural person

presented in the original or in an officially certified copy thereof. The documents referred to in

paragraph 1 (b). a), d) and (e)) a natural person shall submit a copy of.



(3) the manner and form of submission of documents referred to in paragraph 1 are

laid down in § 9 para. 3.



§ 7



The request of the natural person pursuant to § 94 paragraph. 4 and 5 of the Act



(1) a natural person to the application filed pursuant to § 94 paragraph. 4 and 5 of the Act

a natural person shall be accompanied by the questionnaire individuals stating



Basic identification data), to the extent a name, surname, birth

If the number was not assigned, date of birth,



(b)), indicating their amount of income after deduction of compulsory statutory levies

for the period between the filing of the earlier application and



(c)) the data that has changed in the course of the validity of the certificate of physical persons

and have not been notified in accordance with § 10.



(2) the information referred to in paragraph 1 (b). (b)), and (c)) a natural person is illustrated by

the documents referred to in section 6 (1). 1 and 2, and the manner and form prescribed by

in section 9.



§ 8



A request for a document in accordance with § 99 paragraph 2. 4 and 5 of the Act



(1) the application for the document filed pursuant to § 99 paragraph 2. 4 and 5 of the Act, the physical

the person shall be accompanied by the questionnaire, stating



Basic identification data), to the extent a name, surname, birth

If the number was not assigned, date of birth,



(b)), indicating their amount of income after deduction of compulsory statutory levies

for the period between the filing of the earlier application and



(c)) the data that has changed in the course of the validity of the document and have not been

notified in accordance with § 10.



(2) the information referred to in paragraph 1 (b). (b)), and (c)) a natural person is illustrated by

the documents referred to in section 6 (1). 1 and 2, and the manner and form prescribed by

in section 9.



§ 9



The method and form of filing of applications and notification of changes



(1) the request of the natural person, the application for the document, the Declaration of waiver

obligations of confidentiality, representations of physical persons of incapacitation and

Declaration eligibility to the personality shall be submitted in paper form or

the data boxes are delivered to the national security authority or, in the

e-podobě1).



(2) a natural person and a questionnaire the questionnaire shall be submitted in paper form and

data are delivered to the mailbox of the national security office or in

electronic form in the format specified on the website

The National Security Bureau. The filing in electronic form can be done

even on a technical medium.



(3) the documents referred to in articles 6 and change notification under section 10 may be filed in

paper form or delivered to the mailbox of the national

Security Office or in electronic podobě1).



(4) electronic templates of the forms in annexes 1 to 6, 8 to 11

and 13 of this Decree published by the national security agency on its

website.



(5) the appearance of the paper form of the completed questionnaire by natural persons and

completed questionnaire must match the appearance of the display in the electronic

form.



§ 10



Limit the range of reporting changes in the questionnaire data of a natural person or, in the

questionnaire



(1) a natural person who filed the request of the natural person or the natural person

the person who made the request for the document, or the natural person who is

holder of a certificate issued by a natural person or document indicates

The National Security Bureau only changes



and identification data)



(b) the address of the place of residence),



(c)) the address for service,



(d)) of the employer,



e) belonging to associations, foundations and generally beneficial companies,



f) the acquisition or disposal of movable property whose value exceeds 100 000 CZK

or five times its average monthly income after the deduction of

compulsory statutory levies, whichever amount is higher,



(g)) the acquisition or disposal of immovable property,



h) criminal proceedings, including indication of when and by whom was initiated and

the reason,



I) regulation enforcement,



j) to achieve higher degrees of education,



the incurrence of liabilities), whose nominal value, individually or in the aggregate

exceeds 100 000 CZK, or five times its average monthly

income after deduction of compulsory statutory levies, according to which the amount of the

is higher,



l) the emergence of claims whose nominal value, individually or in

Summary exceeds 100 000 CZK, or five times its average

monthly income after deduction of compulsory statutory levies, according to

that amount is higher,



m) the particular installment of the commitment, if its value exceeds 100 EUR or

five times its average monthly income after deduction of compulsory

statutory levies, whichever amount is higher,



n) data to the person of husband (wife) or partner (partner) and people

over 18 years of age living at home with her; a natural person, which

the application for the document or is the holder of, a change of these data does not.



(2) a natural person declares in the range of items of a questionnaire of physical persons


referred to in annex 6 to this Ordinance changes referred to in paragraph 1 (b).

a) to (e)), h, i), and (n)). Natural person declares in the range of items

the questionnaire in Appendix 6 to this Ordinance changes referred to in paragraph

1 (b). a) to (e)), h and i). Fact pursuant to paragraph 1. I) to)

evidenced by a documents in the form set out in § 6 (1). 2 and the manner and

in the form laid down in section 9.



§ 11



Regulation (EEC)



Decree 527/2005 Coll. laying down patterns in the field of human resources

the safety and security of the eligibility and the lists of documents

accompanying the application for issue of a certificate of a natural person and to the request for

proof of the safety of natural persons, and method of administration

These requests (Decree on safety of personnel), is hereby repealed.



§ 12



The effectiveness of the



This Decree shall enter into force on 1 January 2000. January 2012.



Director:



Ing. He returned in r.



Annex 1



DECLARATION OF THE NATURAL PERSON OF INCAPACITATION



(section 7 of Act No. 412/2005 Coll.)

Name and surname:



Date of birth:



Address of residence:



1. I declare that I am – I'm not fully enjoys.



2. I declare that I am/was in the past and was not limited to-/and incapacitation.



3. in the event that you are in point 1 comment/and negatively or positively, in paragraph 2, please indicate:



and the name of the Court) that the relevant decisions issued:



...........................................................................................

...........................................................................................



(b)) reference number of the Court's decision:



...........................................................................................

...........................................................................................



(c)) the time period for which you have been limited in incapacitation:



...........................................................................................

...........................................................................................



V ....................... dne ....................



...............................

The signature of the

________________

* Delete where inapplicable



Annex 2



Model Of The Certificate Of ELIGIBILITY To The PERSONALITY



(section 13 of Act No. 412/2005 Coll.)



Name and surname:



Date of birth:



Address of residence:



1. I declare that I am-I'm not being treated by a psychiatrist and I-I'm not in the care of a psychologist.

I agree that in the past was not treated/and a psychiatrist, and was-not

in the care of a psychologist.



2. At present, I am not aware of the psychological difficulties.-



3. in the event that you are in points 1 and 2, expressed in the affirmative, please indicate/:



and) date of examination (time period)



...........................................................................................



(b)) the reasons which have led You to find a psychiatrist or psychologist



...........................................................................................



(c)) method of treatment-outpatient-inpatient hospitalization



...........................................................................................



d) Diagnosis



...........................................................................................



(e) the name of the professional device) name and surname of a psychiatrist or psychologist



...........................................................................................



(f) Please list all your psychological) difficulties and describe the circumstances occur (intensity,

the frequency, duration, treatment)



...........................................................................................



V ............ dne ............



........................

The signature of the

________________

* Delete where inapplicable



Annex 3



The model designation of the body



(give name and address of the authority of the State, a legal entity or business

natural persons)



ABOUT THE REMARK OF E N S



the fulfilment of the conditions for access to EU classified information to the level of classification of the reserved (§ 6 of the law No. 412/2005)



NOTICE

of compliance with the conditions for access to the RESTRICTED classified

information (section 6 of the Act n. 412/2005 Coll.)



Name and surname

Name and surname



Maiden name

Maiden name



Date of birth

Date of birth



Place of birth

Place of birth



Country of citizenship

Citizenship



V(In) ..................... Day (Date).....................



Compliance with the conditions referred to under section 6 (1). 2 Act No. 412/2005 Coll., on the protection of classified

information and security, as amended, issued and checked:

Compliance with conditions according to § 6 section 2 of the Act n. 412/2005 Coll., on the

protection of classified information and security eligibility, has been verified by and

the Notice has been issued by:



Name and surname

Name and surname



The signature of the

Signature



Stamp

Stamp



Annex 4



The model designation of the body



(give name and address of the authority of the State, a legal entity or business

natural persons)



P O U E N N S



According to § 9 para. 1/section 11 para. 2 of the law No. 412/2005 Coll., on the protection of classified information

and safety eligibility



BRIEFING

According to § 9 par. 1/section 11 par. 2 * of the Act n. 412/2005 Coll., on the

protection of classified information and security eligibility



The person below was familiar with its rights and obligations in the field of the protection of

of classified information. She was acquainted with the content of the law No. 412/2005 Coll., on the protection of

on the security of classified information and eligibility, as amended

(hereinafter referred to as the "Act") and with the content of the implementing legislation. Was made aware

with the obligations provided for in § and § 66 paragraph 65. 1 of the Act, in particular, with the obligation to:



The person named below has been briefed on his/her rights and duties in the area

of protection of classified information. He/she has been acquainted with the content

of the Act n. 412/2005 Coll., on the protection of classified information and security

eligibility (hereinafter "the Act"), and with the content of the implementing legal

regulations. He/she has been acquainted with duties laid down in § 65 and section 66 par. 1

of the Act, in particular with the following:



and to comply with the obligations laid down in) protection of classified information,

and comply with it) imposed obligations in protecting classified information;



b) keep confidential classified information that has or should have access, if it is not

exempted from this requirement by the competent authority,

(b)) that hold classified information in confidence, to which he/she has or had access,

unless he/she has been released from this duty by the responsible authority;



(c)) do not allow access to the classified information to any unauthorized person.

(c)) to prevent access by unauthorized persons that classified information.



There was familiar with all the consequences of the violation of the obligations provided for by law, in particular

with the danger of criminal prosecution or penalty for committing an administrative offense.



Further he/she has been briefed on all consequences arising from the breach of duties

imposed by the Act, in particular on the danger of a criminal prosecution or imposing

sanction for committing an administrative infraction.



The person below was acquainted with the regulations has not been NATO

was-transfer with EU regulations

It was not made aware of the provisions in SARA



The person named below:

has been-has not been * briefed on the regulations of the NATO

has been-has not been * briefed on the regulations of the EU

has been-has not been * briefed on the regulations of the SARA



V(In)................ dne (Date).....................



Lessons conducted by Knowledgeable person

The briefing made by The briefed person



Name and last name first name and last name

Name and surname, Name and surname



Signature date of birth

Signature Date of birth



Stamp certificate natural person/Number *

Stamp Number of Certificate of Security

Clearance/*

Release date announced

Issuance date of notice



The signature of the

Signature

________________

* Delete where inapplicable



Annex 5



The Pattern Of The REQUEST Of The NATURAL PERSON



(article 94, paragraph 1, of Act No. 412/2005 Coll.)



I request the issue of a certificate of physical persons



Name and surname:

Date of birth:

Place of birth:

Classification:



The justification for having access to EU classified information

(including functions or activities within or leaving the employment,

Member or the like relation, based on which the certificate is to be issued to natural persons):



...........................................................................................

...........................................................................................



I declare that the information provided in the application and its annexes is true,/and

I the terms safety control, and I agree with you.



V .................. dne .................



..................................

The signature of the natural person



Confirm the justification for the need for access to classified information


The designation of the responsible person/Safety Director or whoever will provide utajovanouinformaci

Designation of entity:

Name and surname:

Date of birth:

Access to classified information, a necessary result of filling determined pursuant to

§ 69 para. 1. (a). (b)) of the Act (specify the designation of the place or feature and inclusion in this list):



Specification of classified information on a given site or feature has already been provided or

arose, and classified information will be provided in the future or may arise:



...........................................................................................



V .................. dne .................



..................................

The signature of the



Stamp

________________

* Delete where inapplicable



Annex 6



A Model QUESTIONNAIRE INDIVIDUALS/QUESTIONNAIRE



(§ 95 of Act No. 412/2005 Coll.)



Photos



1. basic identification data

1.1 Name

1.2 Surname

1.3 maiden name

1.4 Previously used the surname

1.5 academic degree

1.6 date of birth

1.7 social security number

1.8. Place of birth

1.2 birth of District

1.10 the State of birth (if not Czech Republic)

1.11 the citizenship of current

1.12 country of citizenship the previous

1.13. Marital status



2. the address of the place of residence

2.1 Street

2.2 in no.

2.3 No./registration

2.4 the municipality

2.5 ZIP CODE

2.6 State



3. The address of another place where you stay or have stayed (and)

continuously for more than 90 days in the past ten years

3.1 Street

3.2 number

3.3 indicative Number/registration

3.4 the village

3.5 ZIP CODE

3.6 the State

3.7 Od do



4. the address for service and other contacts

4.1 Street

4.2 No.

4.3 indicative Number/registration

4.4 the municipality

4.5 ZIP CODE

4.6 State

4.7 Phone

4.8 Email

4.9. data mailbox ID



5. data on the identity document



(only for foreign nationals)

5.1 document type

(passport, identity card, etc.)

5.2 Number

5.3 State Edition

5.4 release date

5.5 Force to



6. the employer

6.1 the employer

6.2 identification number

6.3 Street

6.4 the number

6.5 Number guidance

6.6 the municipality

4.2 POSTAL CODE

4.2 Phone

6.9 the State

6.10 suggest that the job Description/features and activities

6.11 Employed from



7. Previous employers

and in the last 10 years) in the case of an application of a natural person for the classification of Confidential

and requests for the document, or for the period from 15 years of age, depending on which is shorter



(b)) in the last 15 years in the case of a request of the natural person for security classification secret

or for the period from 15 years of age, depending on which is shorter



(c)) in the last 20 years in the case of an application of a natural person for the classification of top secret,

or for the period from 15 years of age, depending on which is shorter



7.1 the employer

7.2 identification number

7.3 Employed (a) from The

7.4 if any further clarification, if you cannot give the exact name of the employer and the identification number



8. jurisdiction to foundations, associations, and generally beneficial companies in

the last 5 years

8.1 Name

8.2 identification number

5.2 From The

5.2 Features



9. The matrimonial property regime



5.7 Persons financially dependent on you

9.1.1 Name

9.1.2 Surname

9.1.3 birth number/date of birth, social security number, if it is not allocated

9.1.4 relationship to your person



9.2 the common property of the spouses



Yes No



9.3. Matrimonial property regimes

(in the case of a positive reply in detail, specify)

Yes No



5.8 Finance

(bank accounts, insurance policies, savings accounts and credit

cooperatives, life insurance, pensions, savings, and other financial products, and disposition

the rights to the account of other persons, with the exception of item 9.4.4)

9.4.1 the type of

9.4.2 the number

9.4.3 the

9.4.4. The current balance

9.4.5 Currency

any additional observations 9.4.6

9.4.7 Above regular deposit of the natural person



9.5 Investment tools

(pursuant to section 3 of Act No. 256/2004 Coll. on the capital market,

as amended)

9.5.1 the kind of

9.5.2 ISIN

9.5.3 identification of Other investment tools

9.5.4 unit cost

9.5.5 Currency

9.5.6 method and date of

9.5.7 any additional observations



6.0 annual income after deduction of compulsory statutory levies for the past 5 years, in the case of the submission of

the request pursuant to § 94 paragraph. 4 and 5 of the Act or under § 99 paragraph 2. 4 and 5 of the Act for the period, which

Since putting this information in a previous application



9.6.1 9.6.2 9.6.3 Amount Currency Year



6.0 other income other than wages or salary less the compulsory statutory levies for the past 5 years,

in the case of a request referred to in section 94 para. 4 and 5 of the Act or under § 99 paragraph 2. 4 and 5 of the Act for the period

Since the launch of these data in the previous application (výsluhový post, receive

from a business, rental income, income from the sale of immovable property, income for the stay in a foreign

Mission, social benefits, unemployment benefits, maternity allowance, maintenance, gifts, inheritance, etc.)



9.7.1 Year 9.7.2 sort of 9.7.3 9.7.4 Currency Above

6.1 movable property

(depending on the species, whose value in the case of one species exceeds 100 000 CZK, e.g., personal collection

car, antiques, equipment, electronics)

9.8.1 the kind of

9.7.2 the number of pieces

9.8.3 the total value



6.2 real estate



9.9.1 shall be conducted at the land registry office (in the case of real estate outside of the Czech republikuuveďte address)

9.9.2 real estate Description and method of its use

9.9.3 Way acquisition

9.9.4 Custom price estimate

9.9.5 the acquisition price

9.9.6 Currency



9.10 the relationship to the object of housing



9.10.1

The owner/co-owner of the payer of the rent of housing cooperatives



staying free of charge other

9.10.2. Average monthly housing costs (rent, payments for services connected with the operation of an object housing)



9.11 financial receivables



9.11.1 legal reason

9.11.2 Above

9.11.3 Currency

9.11.4 the debtor

9.11.5 any additional observations



9.12. Financial liabilities



9.12.1 legal reason

9.12.2 Above

9.12.3 Currency

9.12.4 the creditor

9.12.5 the average monthly payments

any additional observations 9.12.6



10. Criminal proceedings

State all criminal prosecutions were conducted against you, regardless of theresult

control any expungement of punishment and the certificate is in the conditional sentences, including shortened procedure.



10.1 the legal designation of an offence

10.2 Date commencement of prosecution

10.3 the prosecution led the (designation authority participating in criminal proceedings, the file marks, number)

10.4 the date and the method of their

10.5 a detailed statement



11. the Mandated enforcement



(execution, deductions from wages, assets, etc.)

6.9 the authority which ordered the execution of decisions

11.2 the kind of

11.3 the Year regulation enforcement

7.1 detailed statement



12. Highest completed education

12.1 name of the school

12.2 the municipality

12.3 State

7.7 Year end

12.5 Degree education



13. Continuous stay abroad longer than 90 days

13.1 State

13.2 place of residence

13.3. Detailed comments on the stay (reason, who sent the funds to cover the costs of the stay, etc.)

13.4 from to



14. Personal contacts with foreign nationals or nationals

the citizens of the United States living in non-Member States of the European Union

or the North Atlantic Treaty Organization, with the exception of contacts

arising out of employment or official duties after 1990,

If you can reasonably assume that it is a significant contacts



14.1 detailed statement



15. jurisdiction, contacts and links with the former and current security

the services of a foreign power or its services in the news and on the

the ingredients listed in § 14 para. 3 (b). and) law, except for contacts

arising out of employment or official duties after 1990



(i.e. the former State security folder with rozvědným or kontrarozvědným

focus, including military counterintelligence, intelligence management

The General staff of the Czechoslovak people's army or the Department of the Interior

Protection Corps remedial education.)



15.1. A detailed statement of



16. use of narcotic drugs or psychotropic substances, as referred to in the Act

governing the area of substance abuse and alcohol use, playing on

licenced and participating in betting games or treatment

addiction to narcotic drugs or psychotropic substances, alcohol and treatment

compulsive gambling

16.1 the narcotic or psychotropic substances



16.1.1 the kind of

16.1.2 detailed statement (with regard to the frequency of use, in the past and in the present, including

a one-time experience, applied/used the types and quantities of narcotic drugs and psychotropic substances, etc.)



10.1 Alcohol



16.2.1 a detailed statement



16.3. Playing on the slot machines, and participation in betting games



16.3.1 detailed statement (with respect to the frequency in the past and in the present, a kind of game,

inserted/pasted amounts, etc.)



10.2 Treatment of addiction to alcohol, narcotic drugs and psychotropic substances, treatment of pathological

gambling, and it's in the past or in the currently



16.4.1 detailed statement



17. The previous security management



(security screening, authentication, security)


17.1 the confidential, secret, top secret, security eligibility.

17.2 the outcome of proceedings Stopped in top ten best-seller Released

17.3. the authority of the State, that the proceedings were conducted by the



18. A detailed curriculum vitae



Write free form. We recommend the following breakdown: family,

school and preparing for employment, existence, independence and partnership

family life, employment, any business activity, operation

business, membership in the organs of legal persons, the way of leisure

of time, physical and mental health. In the case of an application pursuant to § 94 paragraph. 4 and

5 or under § 99 paragraph 2. 4 and 5, limit the content of the resume for the period from

of the earlier application.



19. the husband (ka) or partner (ka) and persons over the age of 18 living in the

a household with a natural person



(does not fill in the application for the document)

19.1 the name,

19.2 last name

12.0 maiden name

19.4 Previously used the surname

12.1 date of birth

12.2 your social security number

12.2 place of birth

12.3 the County of birth

12.4 the State of birth (if not Czech Republic)

19.10 the citizenship of current

19.11 the citizenship of the previous

19.12 the relationship to your person

19.13 the employer

19.14 the identification number

19.15 argued for a detailed description of job/function

19.16 Employed from



Annex 7



The model designation of the body



(enter the name of the body issuing the certificate)

O WITH A D E N N S

natural persons

Certificate of Security Clearance/Certificat d ' habiliation personnelle

Number:

Number/Numéro



Name and surname

Name and Surname

Nom et prénom



Maiden name

Maiden Name

Nom de naissance



Date of birth social security number

Date of Birth Personal Well.

Date de naissance Numéro d ' identification personnele



Place of birth

Place of Birth

Lieu de naissance



Country of citizenship

Nationality

The Belgian



Classification level

Classification Level

Niveau de classification



Release date valid from valid until

Date of Issue Valid from Date of Expiry

Date de délivrance de Validité á partir d ' expiration Date



Signature of the authorized representative of the imprint of the official stamp

The signature of the Competent Representative Official Stamp/Cachet offciel

Signature du représentant autorisé



Annex 8



Pattern For Issuing A Certificate Of A NATURAL PERSON For A FOREIGN POWER



(article 57, paragraph 2, of Act No. 412/2005 Coll.)



I request the issue of a certificate of a natural person for a foreign power:



A. identification data:



Name and surname:

Date of birth:

Place of birth:



B. classification, for which the certificate is of a natural person for a foreign power required:

...........................................................................................



(C) a valid certificate number of the natural person and the classification level for which it is issued:

...........................................................................................



(D) the rationale for buying access. a natural person to the classified information to a foreign power (including the

position held, the nature of the activities in which the natural person will have access

the classified information to a foreign power, the identification of the body which will be the physical person classified

information to a foreign power to provide):

...........................................................................................

...........................................................................................

...........................................................................................

...........................................................................................

...........................................................................................



E. the period for which a natural person is sought to issue the certificate for a foreign power:

...........................................................................................



(F) the address for service:...........................................................



V ..................... dne .....................



.....................

The signature of the



Annex 9



Pattern RECOGNITION Of SECURITY PERMISSIONS To Request Of The NATURAL PERSON



(article 62, paragraph 2, of Act No. 412/2005 Coll.)



I ask for the recognition of the security permission issued for natural persons:



The name or names, and surname:



Date and place of birth:



Country of citizenship:



Based on the security permissions no........................................... issued by

...........................................................................................



(The name of the issuing institution and the State)



day.............. valid until.............. classification ... ... ... ... ... ...



The reason why it has to be a recognition of the security permission is carried out (including the position held, the nature of the activities in which the natural person will have access to EU classified information, the identification of the person who will be the person to provide classified information):-...-----------------------..

...........................................................................................

...........................................................................................

...........................................................................................

...........................................................................................

...........................................................................................



The period for which recognition is to be done:..................................................



Address for service of the recognition of the security permissions of a natural person:

...........................................................................................

...........................................................................................

...........................................................................................



Annex: an official translation of the security permission issued by a foreign power or its certified copy

or confirmation of the Office of a foreign power, that is in the scope of protection of classified information, that

the applicant is in possession of the appropriate security permissions.



V .............. dne ..............



..........................................

Signature of the holder bezpečnostníhooprávnění

or of the person responsible of the Office of foreign

power, which is in the scope of protection

of classified information



Annex 10



The model designation of the body



(give name and address of the entity in which the proceedings are conducted)

P O U E N N S



According to § 58 para. 5 of law No. 412/2005 Coll., on the protection of classified information and the security of the eligibility



The person below was familiar with its rights and obligations in the field of the protection of classified

information. She was acquainted with the content of the law No. 412/2005 Coll., on the protection of classified information

and about security, as amended by later regulations (hereinafter referred to as the "Act") and the content

the implementing legislation. There was familiar with the obligations that are stipulated in sections 65 and

section 66 paragraph 1. 1 of the Act, in particular, with the obligation to



and to comply with the obligations laid down in) protection of classified information,

b) keep confidential classified information that has or had access to, unless this

exempted from the obligation by the competent authority,

(c)) do not allow access to the classified information to any unauthorized person.



There was familiar with all the consequences of the violation of the obligations provided for by law, in particular

resulting in a criminal prosecution or penalty for committing an administrative offense. Was also

advised that the details of the national security authority are recorded and may be used

manner prescribed by law.



The lesson is done for the purposes of...........................................................

(enter the name of the procedure)

kept under....................................... In this proceeding will have an educated person

(enter the file description of the case)

access to classified information up to the classification of..................................., including,

a to z oblasti ....................................................



V ................ dne ................



Lessons conducted by Knowledgeable person



Name and surname: first name and surname:



Signature: date of birth:



Stamp

Signature:



Annex 11



A Model Request For DOCUMENT



(article 99, paragraph 1, of Act No. 412/2005 Coll.)

I ask for the release of the document on security of natural persons:



Name and surname:

Date of birth:

Place of birth:



Sensitive activities:

...........................................................................................

...........................................................................................



The provisions of the law, according to which it will be exercised in such a sensitive activity:

...........................................................................................

...........................................................................................



I declare that the information provided in the application and its annexes is true, I


the terms of the safety control, and I agree with you.



V .................. dne ..................



....................................

The signature of the natural person



Confirm the justification for the performance of activities including a description of a particular sensitive places or features

related to the performance of sensitive activities:

...........................................................................................

...........................................................................................



The responsible person or the authorized person

Designation of entity:

Name and surname:

Date of birth:



V .................. dne ..................



....................................

The signature of the



Stamp



Annex 12



Pattern

THE NATIONAL SECURITY AGENCY

Post offices. compartments. 49 150 06

Prague 56



(D) TO (L), AND (D)

about the safety of natural persons



Number:



Name and surname:



Maiden name:



Birth date: social security number:



The place and State of birth:



Country of citizenship:



Release date: valid from: valid until:



Signature of the authorized representative of the imprint of the official stamp

The National Security Office, the National Security Office



Annex 13



Model Declaration Of WAIVER Of CONFIDENTIALITY



pursuant to § 52 para. 2 the tax code



The data to the physical person requires the national security agency in the framework of the implementation of the operations of the security

proceedings under Act No. 412/2005 Coll., on the protection of classified information and security

eligibility, as amended.



The tax entity



Name and surname:

Maiden name:

Social security number:

Date of birth:



I, the undersigned (s), zprošťuji tax administrator and any other person involved in the správědaní obligations

secrecy concerning the data relating to me, and the data that were used in the taking of evidence

duties in the administration of taxes, to the extent necessary for carrying out safety control by

Act No. 412/2005 Coll., on the protection of classified information and the security of the eligibility, as amended by

amended.



I agree, that the tax or any other person involved in the administration of taxes was totozproštění

confidentiality provided a copy to the confirmed national security authority.



V .................. dne ..................



....................................

The signature of the