Maryan Aden

01.2013

Disclose all contacts and/or relationships with inmates/offenders who are currently under the supervision of ODRC
Failure to follow the above instructions for items 1-5 will result in the packet being returned
Failure to follow item 6 will result in a failed background check
Background checks may include a review of criminal record, driving record, credit history, and social media, among other reviews
Additional reasons for failing a background check can include but are not limited to:
Certain criminal or driving offenses
False or omitted information
Previous removal from ODRC employment
Packet contains:
Authority for Release of information (DRC1404)
Employer Immunity Disclosures (4113.71)
Independent Contractor Information (DRC1681)
Staff Nexus (DRC, )
Aden Maryan 9519urban hollow ct grove city franklin ohio 43123OH Kenya
Maryanaden@yahoo.com F B/AA 12/31/2000
Maryan Aden 01/18/24
Mohamed
Page 1 of 3DRC-1681 E (06/2023) Policy: 34-PRO-07
EXPLANATION AND INSTRUCTION: This questionnaire will provide the Ohio Department of Rehabilitation and
Correction with information needed to determine your eligibility for approval as an independent contractor
Please answer all questions fully, truthfully, and accurately
If any questions are not answered, attach a written statement specifying the reasons therefore
Falsification will result in your bid being disqualified
Please Print/Type Name
Ohio Department of Rehabilitation and Correction

Telephone

Duties (for identification purposes): Reason for Leaving:
Telephone Number: Name of Supervisor, Name(s) of co-worker(, Voluntary Part-time Full-time
Military Service Not Employed
From (Mth, To (Mth/Year):
By signing below, the vendor agrees to abide by all agency policies, particularly those relating to confidentiality of information and security practices
Duties (for identification purposes): Reason for Leaving

Summary