I, name……………………, am a job/position in institution …………………...,

at name of the institution…………………………………………………… . I confirm that the following four elements of the Baseline Personnel Security Standard (BPSS) check for the proposed FRS research applicant full name of applicant….………………………………………………. DOB of applicant (DD/Month/YYYY)……......... to access FRS restricted survey data through the UK Data Archive’s safe room have all individually been fully verified;

·  Identity, (Please confirm documentation inspected e.g. EU/non EU Passport, Driving Licence, Birth Certificate etc) Please state document name, reference number and date of issue

·  Document name …………………..,

Ref No…………………,

Date of issue (DD/Month/YYYY)…………….

·  Employment History (for a minimum of past 3 years

·  Nationality and Immigration Status,

·  Criminal Record (unspent convictions only),

See guidance - http://www.dwp.gov.uk/docs/aguidefordwpcontractors.pdf or

http://www.cabinetoffice.gov.uk/sites/default/files/resources/HMG%20Baseline%20Personnel%20Security%20Standard%20V3%201a.pdf

for supportive information.

Name in full, capitals ..……………………………………..

Signature ………………………………………

Date ..……………………………………..