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Judicial Watch • Mateen certification documents pg 39

Mateen certification documents pg 39

Mateen certification documents pg 39

Page 1: Mateen certification documents pg 39

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Number of Pages:1

Date Created:June 22, 2016

Date Uploaded to the Library:June 22, 2016

Tags:wackenhut, applicant, license, temporary, certification, Mateen, telephone, AGENCY, staff, documents


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TEMPORARY CLASS LICENSE
CHECKLIST FOR INDIVIDUAL APPLICANT
(To completed DOACS/DOL Regional Office Staff)
Agency Name: _W=AC:::K_::E:.N::.H:::U_::T_
Address:
4200 WACKENHUT OR, SUITE 102, PALM BEACH GARDENS, FL, 33410
License#:
AB9600012
Telephone#:
561-627-0068
ApplicantName: -=O:::M:.:A:.:R_:MA:.:_:T_:E_:E:.:N_ _~---~--Address:
490 DOVER CT, LUCIE, FL, 34983
~=~d.--
Licen #(if applicable):---------
Telephone#:
772-621-8581
Expiration temporary license may issued applicant meeting the following criteria: currently licensed and employed as, has made application for, Class CC, MB, and Has been given approval BLI. Date:
Time _The employer has ceritified the applicant mentally and emotionally stable completing the
Agency Character Certification attaching DD-214 form. Fingerprint Card (when aJ?plicabe)
Have the applicant sign below:
Ap~na ,pcinted
108088
Temporary License Number
Received By: Processing Personnel/bate
Mailed To: