PSPLA - Details of employed certificate holders form [pdf, 402 KB]
...an offence this may result in your certificate being suspended or cancelled. The certificate holder consents to the Ministry of Justice undertaking a check on any offences the certificate holder has been convicted of, using the information contained in this application. Enter 'Yes" or 'No' I certify that the above particulars are true and correct. Enter 'Yes" or 'No'