Training History Report
SC Criminal Justice Academy
Reported by Acais® Readiness Suite oananon4
For: Taylor, Timothy
Academy 1D 0877-2803
Taylor, Timothy Pern Stats Acve Don 1985 EEOC Blak
SSN Gender Male
Ga z
Ms Re
Carrent
Organtzation Active Dates TileRank Employment Type Appointment Type [States
SC Sate Unive Poice 102072021 - 4122004 | Oficer hss 1 LEO Tmetve
Department (Primary)
any Plice Det onioi2020=t0ri92031 | omst Clas 1L60 chief Bis
Faireld Co. sherfs Office 05062019-08282020 | ofier Clas 1 LE0 Inactive
SC Ste Universi Police ove22019=04012019 | omtcer Not Cen ae
Department
Atlantic Beach Police Dept. 08/20/2014 - 10/31/2017 | Officer ‘Class 1 LEO. City Police Chief ‘Inactive
Andrews Police Dept, 04/21/2011 - 08/20/2014 | Officer ‘Class | LEO Inactive
Lake Cy Police Dept. 082072008 04222011 | Ofcer Class 1 LEO Inactive
[Cevtieations a z Ses 5
Name Issued Expiration stats
DataMaster Transition 05/11/2009 05/11/2011 Expired (Inactive)
Class 1 Law Enforcement Officer ‘12/05/2008 12/05/2026 ‘Not Employed (Inactive)
(Training Barc: g
Upcoming, Ongoing, & Unconfirmed
Trani
Coure/Te (Course No Training Dates Grade _Saus Category __Hows
Line-Up LineUp2024Jamuay-Febrary aD 72024 asnea MARY yo
Legal Update - Legal Update 2024 - Part 1 0192024 Assigned Hanes’ thas
studio -SCCADVASA Trauma Infomed
Investigative Response io Sexual Assault ané PV. 12772023 Assigned 2hom
Vicims
SiR Yam en gana 11082023 Inrogress MEMO Qn
DUUSPST lnsructor & Specific Skil tsrctr renin
DULSFST Instructor & Specific Skills Instructor 07/29/2028 08/02/2024 NA fee a) 40h Om
2024.07.29 (Field)
Current Period to Date (01/01/2024 - 04/24/2024)
[No current year training data exists.
For Official Use Only
Total Hours (44h 45m)
Page I of 5Training History Report
SC Criminal Justice Academy
Reported by Acadis ® Readines Suite ownanons
For: Taylor, Timothy
Academy ID 0877-2803
Previous Period (01/01/2023 - 12/31/2023)
Draining
Course/Title (Course No, Training Dates Grade Stas __Catesory Hours
Studio - 988 Crisis Care Continaum v227re23 12/27/2023 Completed 0h 30m
Mandatory
Studio -Prelirninary Hearings 11/08/2023 11/08/2023 Completed Ting 030m
5 Mandatory
Legal Update - Legal Update 2023 -Part2 11/07/2023 11/08/2023 Completed Training Ih ism
CDV Annual - DV 2023-Afterthe Call 11/06/2023 11/06/2023 Competed Haney th Om
Line-Up -LineUp 2021 November-December 11/06/2023 11/06/2023 Competed Tne?” thom
Ne Ta tea ee liioouoes 1 aebzs Completed Mandatory hsm
(CDV - Annual -DV 2022 - A Common ,
vam ‘ead Salting 09/01/2023 09/01/2023 Completed 1h 30m
Legal Update - Legal Update 2022. Part 01/11/2023 05/24/2003 Completed th30m
Legal Update - Legal Update 2023-Part 1 05/01/2023 0/01/2023 Completed non” th 15m
Other Periods (through 12/31/2022)
Total Hours (9h 35m)
Training
Course/Title (Course No.) Training Dates Grade Status Category Hours
Legal Update - Legal Update 2021 - Part 2 08/28/2022 08/28/2022 Completed thom
Legal Update - Legal Update 2022 - Part 1 3/28/2022 08/28/2022 Completed thom
‘CDV - Annual - DV 2021 - You Asked, We Mandatory
Answered o1/ig2022 08/28/2022 Completed Tein 3h 0m
Legal Update - Legal Update 2021 - Part 1 ‘08/10/2022 08/10/2022 Completed thOm
CDV - Annual - DV 2020 - Identifying the im
Primury Agaestor osa2/2022 06/22/2022 Completed 2h ism
‘Legal Update - Legal Update 2018-2019 09/17/2020 09/17/2020 Completed Tae thom
Legal Update - Legal Update 2018-2019 January 09/17/2020 09/17/2020 Completed nee thom
EVO Emergency Vehicle Operation ‘09/01/2020 09/01/2020 WA Completed thom
IN-SERVICE 09/01/2020 09/01/2020 NA Completed 83h 0m
Legal Update - Legal Update 2020-2021 ‘08/25/2020 08/25/2020 Completed ee thom
For Oficial Use Only Page 2 0f5Training History Report Repoed by Acad Refers Ste ONDAIHOA
SC Criminal Justice Academy ont Talr Timothy
Academy ID 087-2903
Studio -De-Escalation: Surviving Vesbal Confit Mandatory
Seu ‘0628/2020 06/28/2020 Completed aren ih4sm
See EAS aH conleot MEY, 30m
Line-Up LineUp 2020 Mareh-Apil sivan20 —os/t2020 Completed MABBHY hom
Mandatory
-Up -LinetUp 2020 May-hune 5/11/2020 98/11/2020 Competed enn thom
Legal Update - Legal Update 2019-2020 January 03/05/2020 03/05/2020 Completed Yenenon thom
Lin.ip Line 2020 amar Febrmy 0129020192020 eapiad MESO oa
CDV - Annual - DV 2019- What are the Proper
Chee o1fosr2020 — 01/0672020 Completed 1h30m
‘Studio - Consular Notification & Access 1onsn019 10282019 Competea Maman” thom
LegsUpe-Legs pine 20192000 eS962019—_conHO18 conpens MY yoy
School Resource Officer - School Resource Graduated- Mandatory
Officer 2019.07.15 UE 76.00% 9772622019 Training ee
Legs Updue-Lepi pine 20162017 e719 ——omn20018 connect Moy
CDV- Annual - DV 2018 - Trial Prep 067202019 0625/2019 Completed Haney 1h30m
CDY-Aamal-DV2017-WorREWIRME —eryani9og202019 Complews MSS 2am
Line-Up - LineUp 2017 July-August 6i0s/2019 06/05/2019 Completed thom
Line-Up - LineUp 2017 May-une asioa2019 a6/042019 Completed thom
-Up - LineUp 2018 January-February 6108/2019 96/0472019 ‘Completed hom
Line-Up - LineUp 2019 May-June 05/31/2019 06/04/2019 Completed Taine? thom
Legal Update - Legal Update 2017-2018, 061032019 96/03/2019 Completed Haren thom
Legal Update - Legal Update 2017-2018 Janaury 06/03/2019 06/03/2019 Completed enenery thOm
Line-Up-LineUp 2017 Septemiber-October 06/03/2019 061032019, Competed 1hOm
Line-Up - LineUp 2018 March-April 06/03/2019 96/03/2019 Completed Thom
Line-Up -Linetp 2018 May-June 6103/2019 96/03/2019 Completed thom
Line-Up LineUp 2018 September-October 06/05/2019 06/03/2019 Completed thom
MRN FORM i2ioan017 12/04/2017 N/A Completed hom
INSERVICE 12032017 12/05/2017 N/A Completed 28h0m
Studio - SLED Moving Vehicles & Desdly Force
Rae 0801/2017 08/01/2017 Completed oh30m
Crime Scene for investigators ~ Crime Scene for Depared -
Investigators 2017.05.15 951192017 95/18/2017 05/152017 a
Mid-Level Management - Mid Level Management Departed -
(Field) 2017.01.10 RUT st 01102017 oe
CDV--Anmusl-DV 2016- Appleton oftte Law 01052017 01052017 complica MEREY aon
For Official Use Only Page 3 ofSTraining History Report
‘SC Criminal Justice Academy
Reported hy Acols 0 Realness Suite
oanwn024
For; Taylor, Timothy
‘Academy 1D. 0877-2803,
Legal Update - Legal Update 2016-2017
CDV- Annual - DV 2015 - Changes in the Law
‘Mid-Level Management = Mi
2016.01.12
Specific Skills Instructor - Specifie Skills
Instructor 2015.09.29
Legal Update - Legal Update 2015-2016
Legal Update - Legal Update 2014-2015
‘CDV Annual - CDV 2014 = Overcoming
Obstacles:
Crime Scene for Investigators - Crime Scene for
New Investigators 2014.10.20
Law Enforcement and the Media - Law
Enforcement and the Media 2014.09.17
IN-SERVICE
MRN FORM
Chiefs! Workshop - Chiefs! Workshop 2014.04.16
cov 2013,
LEGAL 13/14
cpv2012
LEGAL 12/13
pv 2011
LEGAL 11/12
MRN FORM
InService
Legal 09/10
Legal 10/11
cov 2010
Dv 2009
Principles of Supervision - CJA (2618)
DV 2008
LEGAL 08/09
Criminal Gang Overview for Street Officers
(6309)
DMT Certification (Spring) (2789)
Basic Law Enforcement (1135)
Physical Abilities Test (1172)
Level Management
01/05/2017
o7isn016
01/122016
09/29/2015
08/04/2015
07/20/2015
o7/e201s
107202014
09/17/2014
08/26/2014
08/26/2014
4/16/2014
0225/2014
02/23/2014
05/21/2013,
08/21/2013
4/21/2012
04/16/2012
142011
1107/2011
02/25/2011
02/25/2011
12/03/2010
06/05/2010
12/18/2009
11/25/2009
11/25/2009
07/28/2009
05/11/2009
12/05/2008,
09/29/2008
01/05/2017
o7nsr2016
01/13/2016
10/01/2015
08/04/2015
072072015,
07/16/2015
1or24n014
09/17/2014
08/26/2014
08/26/2014
os/1si2014
0225/2014
02/23/2014
05/21/2013,
08/21/2013
04/21/2012
04/16/2012
1/142011
11072011
02/25/2011
02/25/2011
1203/2010
06/05/2010
12/18/2009
11/25/2009
11/25/2009
07/28/2009
05/11/2009
12/05/2008,
‘0912972008
For Official Use Only
NA
NA
NA
NIA
NIA
NA
NA
NIA
NA
NA
NIA
NA
NA
NIA
NIA
NIA
NA
NA
NA
NA
NA,
Mandatory
Completed Tining thom
Completed 2h0m
Departed =
01/122016 oe
Departed -
092972015 oh Om
Completed thom
Completed 2h0m
Completed 4h Om
Departed -
10202014 oh Om
Departed -
09/17/2014 oh Oe
Completed 152h Om
Completed 0h Om,
Graduated -
04/18/2014 Isom
Completed 440m
Completed 2h Om.
‘Completed 4h Om
‘Completed 2h 0m
‘Completed 4h Om
Completed hom
Completed 0h Om
Completed 117 Om
Completed 2hOm
Completed 2h 0m
Completed 44h Om
Completed 4h 0m
Completed =
Passed 40h om,
Completed 4h 0m
‘Completed 2h0m
Completed -
Passed 7h 0m
Conipleted =
Passed hn
Completed -
pe 396h 0m
Completed -
Passed bee
‘Total Hours (1007h 30m)
Page 4 ofTraining History Report
‘SC Criminal Justice Academy
Reporte by Acadis® Readiness Suite
For: Taylor, Timothy
‘Academy ID 0877-2503,
oazano24
‘A grade of ## indicates thatthe weights for this class are not valid and grades cannot be calculated,
(Education
‘No education data exist,
scellancous
i
Audit LETS/ACADIS
Has Application
Has been Fingerprinted
Has Birth Certificate
Has Driver's License
Has High Schoo! Diploma
Has Medical Form
‘Training Audit
Complete
‘Yes
Yes
Yes
Yes
‘Yes
Yes
‘Complete
For Official Use Onty
Page 5 of 5PCS: Routine Separation
Date Submitted:
4/16/2024 8:21 PM
Today's Date
4/16/2024
Agency Information
Agency
SC State University Police Department
Agency Email Agency Phone Number
ebrooks2@scsu.edu (803) 536-7188
Officer Information
Name
Timothy Taylor
Academy ID Certification Type
0877-2803 Class 1 LEO
Officer's Address
, Cayoe, South Carolina 28033
Is this individual listed as an agency point of contact (POC) in Acadis? (Training Officer, Reserve
Liason, Agency Head, etc.)
Yes
Separation Information
(For all separations NOT involving misconduct as defined in S.C. Reg. 37-025)
Questions regarding this form? Please email Cert@sccja.sc.gov
Date of Separation CONFIRM Date of Separati ‘Separation Action
411212024 42/2024 Discharged/Fired
Reason(s) for Separation
Other
Other Separation Reason
Timothy Taylor's employment was terminated by the University as a part of leadership realignment by theagency.
There is a pending criminal investigation on There are pending criminal charges on this officer
this officer No
No
PLEASE ENTER SEPARATION MRN INFORMATION
INSTRUCTIONS:
Please enter below the officer's EVO and In-Service training completed at the employing agency within
their most recent renewal period. Questions about this portion of the Routine Separation? Email
Cert@sccja.se.gov
Certification Renewal Date Enter Reporting Year
12/5/2026 2024
YEAR 1 of recertification period
EVO Year Viewed EVO Hours
o °
In-Service Year Viewed In-Service Hours
2023 40
YEAR 2 of recertification period
EVO Year Viewed EVO Hours
0 0
In-Service Year Viewed In-Service Hours
0 0
YEAR 3 of recertification period
EVO Year Viewed EVO Hours
0 0
In-Service Year Viewed In-Service Hours
0 0
ATTENTION:
Ifany Legal Updates, yearly Domestic Violence training, and/or Mental Health training was NOT dor
through the Acadis Portal, please use the link below to fil out an MRN. Once completed, please email
the document to Cert@scoja.sc.gov.If this officer was NOT certified, an MRN is not needed as there is no certification to renew.
MRN DOCUMENT
MRN CLARIFYING COMMENTS
Electronic Signature (Agency Head or Authorized
Representative)
I hereby attest that the reason for separation of this officer does NOT involve misconduct or otherwise
disqualify eligibility for certification as defined in S.C. Reg. 37-025.
AND
| acknowledge that any omission, falsification or misrepresentation of information on this form, by the
signer, may result in certification being denied, suspended or revoked by the South Carolina Criminal
Justice Academy.
Name Official Title Academy ID#
Errol Brooks LieutenantTraining 2305-7397Routine Separation
Caio
Submission Info Reeectov coe at
Completed Date so/19/2021 12:17:16 PM
Reporting Department Perry Police Dept.
Officer First Name Timothy
Officer Last Name Taylor
Response Data
Personnel Change In Status Report: Notification Of Adi
Reporting Department:
Perry Police Dept
‘Agency Emai
10p29137@pbtcommanet
Phone Number:
803-564-5756
Today's Date:
10/19/2021
Section Title: Officer Information
Fiest Name:
Timothy
Middle Name:
Last Name:
Taylor
‘Academy ID#:
0877-2803,
‘Address Line 1:
‘Address Line 2:
City:
Columbia
state:
sc
Zip Code:
29228Certification Type:
Class 1 LE
‘Separation Information
Date of Separation
10/19/2021
Separation Acti
Resignation
Please select appropriate reason(s) for Separation :
Resigned
If selecting ‘Other’ as reason for separation, please detail:
selecting "Termination for violation of Agency policy NOT involving Misconduct’ as reason for separation, please detail:
‘There isa pending criminal investigation on this officer:
No
‘There are pending criminal charges on this officer:
No
Section Title: Electronic Signature (Agency Head or Authorized Representative)
Full Name:
Thomas H Williams
Offical Title:
Mayor
‘Academy ID#:
‘00000000= Routine Separation
‘Submission Date 2017-11-01 13:09:08
South Carolina Criminal Justice Academy
Certification-Compliance
PERSONNEL CHANGE IN STATUS REPORT:
NOTIFICATION OF ADMINISTRATIVE/ROUTINE SEPARATION “S==-#
Reporting Department Alantic Beach Police Dept.
Phone # (649) 660-2084
Today's Date 41-01-2017 Ree, kVp
vmrne D
Academy ID 0877-2803 Sco mr
pean CET CAnOy
NMYRTLE BEACH
sc
29582
Certification Type Class 1 LE
(For all separations NOT involving misconduct as defined in S.C. Reg. 37-025)
PLEASE SUBMIT MRN (MANDATORY RETRAINING NOTIFICATION) FORM INDICATING IN-SERVICE TRAINING
RECEIVED SINCE LAST RENEWAL
Date of Separation 10-31-2017
‘Separation Action Termination
Please select appropriate Other
reason(s) for Separation
Other reason for separation _1, FAILURE TO EFFECTIVELY DISCHARGE HIS DUTIES AS CHIEF OF
(please explain) POLICE FOR THE TOWN OF ATLANTIC BEACH.
2.FAILURE TO IMPLEMENT EFFECTIVE PROCEDURES AND INTERNAL
CONTROLS TO SAFE GUARD SEIZED MATERIALS AND CASH. MISSING
DRUG SEIZURE IS CURRENTLY UNDER INVESTIGATION BY SLED.DO NOT ATTACH. OR SUBMIT, ANY ADDITIONAL DOCUMENTS, OTHER THAN MANDATORY RETRAINING
NOTIFICATION,
| roby attest that the reagon lor separation of his officer doe NOT involve misconduct or olheruse squall eligi lor cerifcaton as defined in
S.C. Reg. 97-025
EMPLOYING AGENCY HEAD
OR AUTHORIZED
REPRESENATIVE
Date 11-01-2017
Name (agency head or QUENTIN ROBINSON
authorized representative)
Official Title (agency head or INTERIM CHIEF
authorized represenativeRoutine Separation
Submission Info
Completed Date 9/1/2020 10:34:15 AM
Reporting Department Fairfield Co. Sheriff's Office
Officer First Name Timothy
Officer Last Name Taylor
Response Data
Personnel Change In Status Report: Notification Of Administrative/Routine Separation
Reporting Department:
Fairfield Co, Sheriff's Office
‘Agency Emal
lee haney@'airield sc gov
Phone Number:
803-815-4114
Today's Date:
(09/01/2020
Section Title: Officer information
First Name:
Timothy
Middle Name:
Last Name:
Taylor
‘Academy ID#:
0877-2803
‘Address Line
‘Address Line 2:
City:
Myrtle Beach
State:
sc
Zip Code:
29582Certification Type:
Class 1 Le
Separation Information
Date of Separation:
08/28/2020
Separation Action:
Resignation
Please select appropriate reason(s) for Separation :
Resigned
‘Accepted employment with another Law Enforcement Agericy
If selecting ‘Other’ as reason for separation, please detail:
{f selecting "Termination for violation of Agency policy NOT involving Misconduct’ as reason for separation, please detail:
‘There is a pending crt
Yes
inal investigation on this officer:
‘There are pending criminal charges on this officer:
No
Upload Mandatory Retraining Notification:
Timothy Taylor MRN. pdf
Section Title Electronic Signature (Agency Head or Authorized Representative) |
Full Name:
Lee Haney
Official Title:
le
‘Academy ID#:
19808-8885Routine Separation
Submission Date 04:01-2019 15:06:41
vere ROUTINE SEPARATION
PERSONNEL CHANGE IN STATUS REPORT: NOTIFICATION OF
ADMINISTRATIVE/ROUTINE SEPARATION
Reporting Department SC State University Police Department
‘Agency Email hsingletary@scsu.edu
Phone # (603) 3087459
Today's Date 04-01-2019 REcrtve
Officer's Name Timothy Taylor APR O2 ‘D
2019
‘Academy ID 0877-2803,
SCCUA CERTIFICA
Address ION
Atlantic Beach
South Carolina
29582
United States
Certification Type Class 1 LE
(For all separations NOT involving misconduct as defined in $.C. Reg. 37-025)
PLEASE SUBMIT MRN (MANDATORY RETRAINING NOTIFICATION) FORM INDICATING IN-SERVICE TRAINING
RECEIVED SINCE LAST RENEWAL
Date of Separation 04-01-2019,
‘Separation Action Resignation
Please select appropriate Resigned
reason(s) for Separation
Other reason for separation
(please explain)DO NOT ATTACH, OR SUBMIT, ANY ADDITIONAL DOCUMENTS, OTHER THAN MANDATORY RETRAINING
NOTIFICATION.
"hreby tit thatthe reason fr separation ofthis ocer does NOT Involve misconduct or ethene squat eb for catticaon as dened in
S.C. Reg. 97-028
EMPLOYING AGENCY HEAD
OR AUTHORIZED
REPRESENATIVE
t
Date 04-01-2019
Name (agency head or Herman Singletary
authorized representative)
Official Title (agency head or Lieutenant
authorized represenativeSouth Carolina State University
SC State University Police Department
POST OFFICE BOX 7516
300 COLLEGE STREET, NORTHEAST
ORANGEBURG, SOUTH CAROLINA 29117-0001.
Joseph D. Nelson
Chief
(603) 536-7188
Fax (808) 586-7168
January 2, 2019 art
Jackie Swindler
SC Criminal Justice Academy
5400 Broad River Road.
Columbia, SC 29212
Dear Director Swindler:
Based on the insufficient evidence regarding Mr. Timothy Taylor from the South
Carolina State Law Enforcement Division (SLED), criminal charges WILL NOT be
pursued against him.
am therefore requesting a waiver from the SC Criminal Justice Academy which will
keep Mr. Taylor from attending the six week training, allowing him to be hired as a Law
Enforcement Officer with the SC State University Police Department.
Sincerely,
Chief of Police
SC State University Police Department
‘Sonth Carotna State University Police Department. P.O. Box 7516, Orangeburg. SC 2917
(08) 836-7188, PAX (805) 536-7163,State of South Carnlina
Office of the Solicitor
Fitteeth Iudieial Cirenit
saber ses
amv a reno
axoxine -
ssn EBorettow scones
Paes mocha seas
JIMMY A. RICHARDSON, II
‘December 3, 2018
Speci ‘Agent Randall Truss
Law Enfotcemont Division
Florence, SC 29506
‘RE: File 33 170142
‘County:
t: Taylot, Timothy
‘Victim: Town of Atlantic Beach
Special Agent Truss,
1am in receipt of the investigative report you generated in reference to a
complaint from the Town of Atlantic Beach concerning missing fimds seized from an
individual arrested by the above natned subject.
‘Thave reviewed it and am writing to inform you that based on the information you
‘uncovered there is evidence of missing funds as well as lack of accounting safeguards
which would help to ensute accurate records of monies taken in by and dispersed from
the Atlantic Beach Police Department and/or the Town of Atlantic Beach. These
safeguards, had they been in effect and available to you, may have eliminated other
‘The mission ofthe Fifteenth Circuit Solicitors Office i to uphold the
‘public's trust in the pursuit of justice and enforcement of the law.explanations for the tissing funds and elevated the evidence you were able to uncover in
this case to proof beyond a reasonable doubt that a particular individual committed a
specific criminal offense. Thut is not the case here and as such insufficient evidence
exists to pursue criminal charges against the above named subject.
If additional information comes to light that materially alters this position, we
may revisit this decision. ‘Thank you for your thorough efforts.
Hah
‘Scott Hixson
Chief Deputy Solicitoroe South Carolina Criminal Justice Academy __-
January 11,2017
Timothy Tavlor
Conway, SC 29526
Case Number: 2017-CJA-09-02
RE: Re-Instatement of Timothy Taylor’s Law Enforcement Certification
Via certified mail, return receipt requested
Dear Mr. Taylor:
‘The South Carolina Law Enforcement Training Council voted to Temporarily Suspend your Law
Enforcement Certification pending the adjudication of the criminal charges for which you were
arrested. It has been reported to the South Carolina Criminal Justice Academy the above
mentioned criminal charges have since been resolved via nolle prosequi, dismissal, or not guilty
verdict. This information was presented to the South Carolina Law Enforcement Training
Council for a determination on whether to re-instate your law enforcement certification and
whether or not to impose any sanctions deemed appropriate.
It has been determined that upon re-employment with a law enforcement agency, your Law
Enforcement Certification will be re-instated without sanctions or restrictions. If you have any
questions, concerns, or feel this response is not fully responsive to your request, please contact
James M. Fennell, General Counsel, at 803-896-7722.
‘As always, please fee! free to contact me if I can be of further assistance.
Sincerely,
Lp
7 -
hoc y ,
Lewis ). Swindler, Jr.
Director
5400 BROAD RIVER ROAD / COLUMBIA, SC 29212-3540 / PHONE: (803) 896-7777 / FAX: (808) 896-7776ce:
Quentin Robinson, Interim Chief
Atlantic Beach Police Department
P.O. Box 5285
North Myrtle Beach, SC 29597
Scan to ACADIS06/26/2014 18:18 2648121 erwrcem>
South Carolina Criminal Justice Academy
Certification-Compliance
= PERSONNEL CHANGE IN STATUS REPORT =
NOTIFICATION OF ADMINISTRATIVE/ROUTINE SEPARATION
tres Fl Dep eons ssn
‘Reporting Department ws Phone # Today's Date
Say P+ cath
‘Officers Name ayy Social Security # ‘Casvent Cerification Date
— comgirn sua
Officers Curent Home Baar Cigitown Zip Code
purast | [7] CHECKoN! Des creo 1 Reserve ofticer
class 1 Lz C1) Chass 2160 Gailer) D Ciass 1LBCO (LEOMailer) CO Class 3SL2 (Limited Duty)
(For ot separations NOT invotving misconduct as defined in S.C. Reg. 38-008)
PLEASE ATTACH MEN QANDATORY RETRAINING NOTIFICATION) FORM
INDICATING INSERVICE TRAINING RECEIVED WHILE EMPLOYED WITH YOURAGENCY
(Please check appropriate reason(s) for separation)
Date of Separation: 08/20/2014 (specify mo/day/yr)
% resigned Retired ____ Deceased
_% accepted employment wih another Law Enforcement Agency . eCcHIvVeID
Medical Leave so a0NA
Miltary Leave Aug 26 204
____- Failure to suecessflly complete basic raining scCJA CERTIFICATION
Failure to sucessfully complete in-service taining
Transfer fort Jaw enforcement classification to Jaw enforcement lasfiation
‘Tenniation for violation of AGENCY policy NOT involving miscondet es defined in S.C. Reg. 38-004 (substandard
pecformance, excessive absentesist, sleeping on duty, ete)
Other (please specify)
thereby tea tha fhe eason for separation of is officer des MQ involve misconduct or otherwise equally eX for
certification as defined in S.C. Reg. 38-004.
EMPLOYING AGENCY HEAD: FS Lifee oY
PRINT NAME: Kaynnera T. Capers. OFFICIAL TITLE: Chief of Police
CIAUSE: MRN:__ CODE: DATE:
Revised 09-09n
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