Free Act 24 Pde 6004 Form in PDF

Instructions on Writing Act 24 Pde 6004

Filling out the Act 24 PDE-6004 form is a crucial step for current and prospective employees of public and private schools, intermediate units, and area vocational-technical schools in Pennsylvania. This form serves as a report for any arrest or conviction of offenses specified under the state's guidelines. It's mandatory for those in the education sector to submit this form accurately and truthfully to meet the compliance requirements set forth by the Pennsylvania Department of Education. Below, you'll find step-by-step instructions on how to fill out the form, ensuring you meet all legal obligations efficiently.

1. Begin by printing your Full Legal Name clearly in the space provided. It's imperative to use the name exactly as it appears in official documents.
2. Enter your Date of Birth in the MM/DD/YYYY format to ensure there's no confusion regarding your age or identity.
3. In the space marked for Any former names, list all names you have previously been known by. This includes maiden names, names from prior marriages, or any legal name changes that have occurred.
4. If you need to report an arrest or conviction for a Reportable Offense, check the appropriate box in Section 2. Remember, the form includes a comprehensive list of offenses considered reportable—make sure to consult this list directly on the form if you're uncertain about any offenses.
5. For each reportable arrest or conviction, provide details including the offense for which you were arrested or convicted, the date and location of the arrest and/or conviction, the docket number, and the applicable court. If you require more space than provided, attach additional sheets ensuring the information is complete and legible.
6. If you have not been arrested for or convicted of any Reportable Offense, check the corresponding box in Section 3. This step is just as important as reporting an offense—it's a declaration of your status relevant to these legal criteria.
7. In Section 4, provide your signature and the date. By signing the form, you're certifying under penalty of law that the information you've provided is true, correct, and complete. Remember, any false statements can subject you to criminal prosecution.

After filling out the form, you must submit it to the administrator or other person responsible for employment decisions within your school entity. This submission process is crucial for compliance and should be done promptly to adhere to any specified timelines. If unsure about where to send the completed form, contact your supervisor or the administration office of your school entity. Accuracy and honesty in filling out this form are paramount, as it aids in ensuring the safety and integrity of the educational environment.

What is the purpose of the Act 24 PDE-6004 form?

The Act 24 PDE-6004 form is designed to ensure compliance with Pennsylvania's Acts 24 of 2011 and 82 of 2012. Its primary purpose is to facilitate the reporting of any arrests or convictions related to specific criminal offenses by individuals currently employed or seeking employment within Pennsylvania's public and private educational institutions. This form aids in maintaining a safe educational environment for students by ensuring that those who work in schools have not been involved in serious criminal activities that could pose a risk to student safety.

Who is required to complete the Act 24 PDE-6004 form?

All current and prospective employees of public and private schools, intermediate units, and area vocational-technical schools in Pennsylvania must complete this form. This requirement encompasses a wide range of staff members, from teachers and administrators to support staff, ensuring a comprehensive background reporting within the educational system.

What offenses must be reported on the form?

Reportable offenses on the PDE-6004 form include a range of serious crimes as outlined under 24 P.S. §§1-111(e) and (f.1). These include, but are not limited to, criminal homicide, sexual offenses, endangering the welfare of children, drug felonies, and DUIs with prior convictions within specific time frames. The form aims to identify any history suggesting a potential risk to the safety and welfare of students.

What happens if an individual fails to accurately report an arrest or conviction?

Failing to accurately report an arrest or conviction for a reportable offense on the PDE-6004 form can result in criminal prosecution under 18 Pa.C.S. §4904, which pertains to unsworn falsification to authorities. This emphasizes the form's crucial role in ensuring transparency and accountability within the educational sector, alongside safeguarding student welfare.

Is there a deadline for submitting the form after an arrest or conviction?

Yes, individuals are required to submit the form within seventy-two (72) hours following an arrest or conviction for a reportable offense. This prompt reporting is critical in allowing educational institutions to take necessary actions swiftly to ensure the ongoing safety of their students and compliance with state laws.

What should an individual do if they have multiple offenses to report?

If more space is needed to report multiple offenses, additional details should be provided on attachments accompanying the PDE-6004 form. This ensures that complete information regarding every relevant arrest or conviction is disclosed, allowing for a thorough evaluation by educational institutions.

Are there exemptions to completing the form?

Yes, current employees who completed a PDE-6004 form on or before December 27, 2011, and have not had any reportable arrests or convictions since then, are not required to complete an additional form. This exemption acknowledges those who have previously complied with reporting requirements and have maintained a clean record thereafter.

Where should the completed form be submitted?

The completed form should be submitted to the administrator or other designated person responsible for employment decisions within the school entity. If there are questions regarding where to send the form, it is advised to contact one’s supervisor or the school entity’s administration office. This ensures the information is reviewed by the appropriate personnel within the educational institution.

Filling out the Act 24 PDE 6004 form correctly is crucial for prospective and current employees of schools in Pennsylvania. However, several common mistakes can jeopardize the process. One such mistake is not providing complete personal information in Section 1. It's important to include all former names to ensure thorough background checks, yet some applicants overlook this detail.

Another mistake is not accurately reporting all arrest or conviction details in Section 2. Sometimes, individuals may forget to list all instances, believing minor offenses need not be reported. However, omitting any reportable offenses can lead to serious consequences, including legal action for providing false information.

Many also fail to check the correct box in Section 3, indicating whether they have or have not been arrested for or convicted of a reportable offense. This simple oversight can cause confusion and delay the application process, as it raises questions about the applicant's attention to detail and honesty.

Inaccuracies in details such as the date, location of arrest or conviction, docket number, and applicable court in Section 2 are common as well. It's essential to be precise since discrepancies can lead to verification issues and potentially disqualify an application.

Some applicants make the mistake of not using additional attachments when the space provided on the form is not enough to list all reportable offenses. This oversight can lead to incomplete disclosure, which, again, has serious implications.

Another common issue is the failure to sign the form in Section 4, which is a crucial step. The signature certifies that all the information provided is true and complete. Without it, the form is considered incomplete.

Applicants often overlook the requirements to submit the form in ink and legibly. Submissions that are hard to read or not in permanent ink may not be accepted, potentially delaying employment processes.

Not checking the list of reportable offenses carefully is another frequent mistake. The list provided in the instructions includes specific crimes that must be disclosed. Misunderstanding or not being aware of which offenses are considered reportable can lead to non-compliance.

Lastly, not updating and resubmitting the form within 72 hours after a new arrest or conviction can create compliance issues. This requirement ensures that employers have the most current information, yet it is often missed by employees.

Avoiding these mistakes is key to successfully completing the Act 24 PDE 6004 form. Paying close attention to the instructions and double-checking all information before submission can help ensure that the process goes smoothly.

When someone fills out the Act 24 Pde 6004 form, it is often part of a process that requires additional information and documentation to be provided. This process helps institutions, especially educational ones, ensure the safety and integrity of their environment. Below is a list of other forms and documents that are frequently used alongside the Act 24 Pde 6004 form. Each document serves a specific purpose and provides essential information in various contexts.

• Child Abuse History Clearance (CY113 form): This form is used to check if an individual has a history of child abuse, which is crucial for working or volunteering in positions that involve contact with children.
• Pennsylvania State Police Criminal Record Check (SP4-164 form): This is a background check conducted by the State Police to identify any criminal history an individual may have within the state.
• FBI Criminal Background Check: For positions requiring a higher level of security or trust, this federal background check provides a nationwide search of an individual's criminal history.
• Employee Health Record (HR-1 form): This document provides a record of an employee's health status and immunizations, ensuring they are fit for their role and do not pose health risks to others.
• Professional Educator’s Disciplinary Action Disclosure: This form is necessary for educators to disclose any disciplinary actions taken against them in their professional capacity, including suspensions, revocations of licenses, or any sanctions.
• Sexual Misconduct/Abuse Disclosure Release (SMD form): Required by individuals seeking employment in schools, this form allows the previous employer to disclose any allegations or findings of abuse or misconduct.
• Employee’s Withholding Certificate (W-4 form): This document is used to determine the amount of federal income tax to be withheld from an employee's paycheck.
• I-9 Employment Eligibility Verification: This form is a legal requirement for all U.S. employers to verify an employee's eligibility to work in the United States.
• Direct Deposit Authorization: This document allows employees’ salaries to be deposited directly into their bank accounts, ensuring timely and secure payments.
• Confidentiality Agreement: Often required by institutions to protect sensitive information, this agreement ensures that employees understand and commit to maintaining confidentiality.

Together, these documents form a comprehensive dossier that institutions can use to make informed decisions about hiring or engaging volunteers. They help in ensuring that individuals working in sensitive or influential positions meet the legal and moral standards expected by the community. Regulatory compliance is achieved through diligent completion and submission of these forms, safeguarding the institution's integrity and the well-being of those it serves.

The Application for Employment/Promotion form, like the Act 24 Pde 6004 form, collects personal identification information, such as full legal name and any former names. This information is necessary to accurately identify the applicant and to cross-reference their details across different systems or databases to ensure the integrity and reliability of the individual's professional status or background.

Similarly, the Security Clearance Form used by government agencies has sections requiring individuals to disclose any arrests or convictions, closely paralleling the Act 24 Pde 6004 form's purpose. The focus on arrests or convictions related to specific offenses, especially those that may impact national security or sensitive positions, mirrors the specificity of the Pde 6004 form in targeting offenses related to education and child safety.

The Professional Licensing Application forms for various occupations ask applicants to report any criminal history, a requirement that mirrors the Act 24 Pde 6004 form. These forms often specify certain types of offenses that are of particular concern for the profession, emphasizing the importance of the applicant's character and behavior in their professional capacity.

The Volunteer Application Form for organizations that work with vulnerable populations, like children or the elderly, often includes a section for the declaration of any criminal records. This parallels the Act 24 Pde 6004 form's intent to protect vulnerable populations by ensuring individuals with certain criminal backgrounds are not granted access.

The Driver's License Application form in many jurisdictions requires applicants to disclose previous convictions or ongoing proceedings for driving offenses, reflecting the Act 24 Pde 6004 form's structure of requiring disclosure of specific offenses. Though the focus differs, the principle of ensuring public safety through background checks remains consistent.

Credit and Loan Application forms typically inquire about an applicant's financial history but can also include questions about criminal convictions if those convictions directly affect the applicant's financial reliability. This resembles the Act 24 Pde 6004 form's approach of seeking specific information relevant to the context, even though the primary contexts of the two forms are different.

The University Admission Application might request disclosure of a criminal background to assess the safety and integrity of the campus community. This is similar to the Act 24 Pde 6004 form, which aims to protect school environments by requiring disclosure of certain types of convictions.

Finally, the International Visa Application form requires applicants to disclose criminal history as part of the vetting process to enter a country, reflecting the Act 24 Pde 6004 form's emphasis on safety and suitability for a particular role or privilege. Both forms use this information to prevent individuals who may pose a risk from being granted access or opportunity.

Completing the Act 24 PDE-6004 form is an important step for current and prospective employees of public and private schools, intermediate units, and area vocational-technical schools in Pennsylvania. This form helps to ensure the safety of the school environment by reporting any arrests or convictions related to specific offenses. To assist you in the process, here's a concise list of dos and don'ts for filling out the form:

Do's:

• Read the instructions carefully before starting the form to ensure you understand the requirements and the list of reportable offenses.
• Fill out the form legibly in ink. This ensures that all the information can be easily read and processed without delays.
• Provide complete personal information, including your full legal name, date of birth, and any former names you've been identified by, to accurately verify your identity.
• Disclose all necessary details about any arrest or conviction of a reportable offense, including the date, location, docket number, and the applicable court.
• Check the correct box in Section 3 to indicate whether you have been arrested for or convicted of any reportable offenses.
• Sign and date the form in Section 4, certifying that all the information provided is true, correct, and complete.

Don'ts:

• Don't leave any sections incomplete. If a section does not apply to you, clearly mark it as "N/A" for "Not Applicable."
• Don't provide false information or omit any details about arrests or convictions, as this could lead to criminal prosecution for unsworn falsification to authorities.

Remember, accurately filling out and promptly submitting the Act 24 PDE-6004 form is not just about compliance; it's about ensuring the safety and integrity of Pennsylvania's educational environment. Should you have any questions regarding this form or the process, do not hesitate to contact your supervisor or the school entity administration office for guidance.

There are several misconceptions about the Act 24 PDE 6004 form that need to be clarified to ensure accurate understanding and compliance:

1. Only teachers need to complete it: It's a common misunderstanding that only teachers are required to fill out this form. In reality, all current and prospective employees of public and private schools, intermediate units, and area vocational-technical schools must submit this form, not just teachers. This includes administrative staff, janitors, and other non-teaching positions.

2. Filling out the form once is enough: Some people believe that once you fill out and submit the PDE 6004 form, you never have to do it again. However, employees are required to submit a new form if they are arrested for or convicted of any reportable offense after their initial submission. This ensures that school entities have the most current information.

3. The form covers all types of arrests or convictions: Another misconception is that the form requires reporting of any and all types of arrests or convictions. The truth is, only offenses that are listed under 24 P.S. §§1-111(e) and (f.1) need to be reported. These are primarily serious offenses, many of which are related to the safety and welfare of children.

4. It's only for offenses committed in Pennsylvania: Some may incorrectly assume that only offenses committed within Pennsylvania must be reported. The Act 24 PDE 6004 form requires the reporting of qualifying offenses regardless of whether they were committed in Pennsylvania, another state, or even another country.

5. Personal information is widely distributed: There is a concern that personal information and details of convictions or arrests provided in the form will be widely distributed or made public. In reality, this sensitive information is handled with confidentiality and is only used by school administrators or those making employment decisions to ensure the safety of students and staff.

6. If no offenses are reportable, the form is unnecessary: This is incorrect. Even if an individual has no reportable offenses, they still must complete the form to certify that fact. This certification is part of the compliance process, ensuring that all employees have been vetted for reportable offenses.

7. Completing the form inaccurately will not result in consequences: Some might believe that inaccuracies on the form, whether intentional or accidental, carry no serious consequences. The truth is, providing false information or failing to accurately report any arrest or conviction for a reportable offense can subject an individual to criminal prosecution.

Understanding these aspects of the Act 24 PDE 6004 form is crucial for ensuring compliance and maintaining the integrity of the educational environment.

Filling out and using the Act 24 PDE 6004 form requires attention to detail and an understanding of its purpose. Here are five key takeaways to ensure compliance and integrity in the process:

1. Understand the Purpose: The Act 24 PDE 6004 form is designed for current and prospective employees of public and private schools, intermediate units, and area vocational-technical schools in Pennsylvania. Its primary purpose is to report any arrests or convictions for offenses that are specifically outlined under Pennsylvania statutes 24 P.S. §§1-111(e) and (f.1).
2. Accuracy is Mandatory: When completing the form, it is crucial to provide accurate and complete information regarding any arrest or conviction of reportable offenses. Inaccurate reporting, including omissions or false statements, can lead to criminal prosecution under 18 Pa.C.S. §4904, which pertains to unsworn falsification to authorities.
3. Reportable Offenses: The form requires the disclosure of a wide range of offenses, from felonies to misdemeanors, related to sexual misconduct, endangerment of children, drug offenses, and more. It is important to review the list of reportable offenses carefully to determine if you have any that need to be reported.
4. Timely Notification: In addition to filling out the form upon employment application, current employees must provide written notice of any arrest or conviction of a reportable offense within 72 hours. This ensures that schools can take timely action in accordance with the law to maintain a safe environment for students.
5. Submission Process: The form must be submitted to the administrator or another person responsible for employment decisions at the school entity. If there's uncertainty regarding whom to submit the form to, contacting your supervisor or the school's administration office for guidance is advised.

By understanding these key aspects, individuals can navigate the requirements of the Act 24 PDE 6004 form more effectively, thus upholding the standards expected of those working in educational settings.