GENERAL INFORMATION INQUIRY - SECTION G

Notice: The following questions and answers will be verified through the use of the polygraph (lie detector) test. If the answer to any of the following is yes, it will be necessary for you to explain in detail including specifics on the continuation sheets provided.

Yes No
1. If it became necessary in the course of your police duties to take a human life, would you have any reluctance to do so due to religious or other beliefs?
2. As an adult, have you ever stolen anything?
3. Have you ever bought or sold any property that you knew was stolen?
4. Has your driver's license ever been suspended or revoked?
5. Have you ever used any hallucinogens such as marijuana, hashish, mescaline, PCP, THC, Peyote, PCE, TCP, angel dust, or any of their derivatives etc? (If yes, age first used, age last used, and total number of usages?)
6. Have you ever used any narcotics such as opium, morphine, codeine, meperidine, methadone, or any of their derivatives such as Darvon, lomotil etc? (If yes, age first used, age last used, and total number of usages?)
7. Have you ever used cocaine, heroin, or LSD? (If yes, age first used, age last used, and total number of usages?)
8. Have you ever used any prescription drugs such as barbiturates, amphetamines, valium, librium, sopors, uppers/downers, etc. without the benefit of a prescription? (If yes, age first used, age last used, and total number of usages?)
9. Have you ever used any prescribed medications for purposes other than that for which they were originally prescribed or intended? (If yes, type and use?)
10. Have you ever used what are described as designer drugs, i.e. substances that are chemically altered in make-up but which give the same effect as illicit drugs, etc.? (If yes, type etc.?)
11. Have you ever sold, been party to the sale, or in any other way been financially rewarded due to the sale of any controlled substances or prescription drugs or any other substance purported to be a controlled substance?
12. Have you ever been involved in glue sniffing or used any other such chemical agents for the purpose of obtaining a state of intoxication?
13. Have you ever applied for and received unemployment compensation, the amounts of which you were not eligible to receive?
14. Are you now, or have you ever, received any type of governmental support such as