F-23

Briarcare Limited

Briarcare House, Harp Lane, Cavendish Road, Clare, Suffolk C010 8PH

Tel: 01787 279000 / Fax: 01787 279007

CRB ENHANCED DISCLOSURE

Disclosure Number Date of issue:

Applicant Personal Details Employment Details

Surname Position applied for

Forename(s) Name of Employer

Other Names Counter signatory details

Registered Person/Body

Date of Birth BRIARCARE LIMITED

Place of Birth Counter signatory:

Gender

(Please tick)

Police Records of Convictions, Cautions, Reprimands and Final Warnings

Information from the list field under Section 142 of the Education Act 2002

Protection of Children Act List information

Protection of Vulnerable Adults List information

Other relevant information disclosed at the Chief Police Officer(s) discretion

Enhanced Disclosure

This document is an Enhanced Criminal Record Certificate within the meaning of sections 115 and 116 of the Police Act 1997.

Use of Disclosure information

THIS DISCLOSURE IS NOT EVIDENCE 0F IDENTITY

Issue No.1 Rev No.0 Issue Date Approved By Page 1 of 1