Arrest and Conviction Form
Act 24 was originally signed into law June 30, 2011 by Governor Corbett and was amended on June 30, 2012 as Act 82 of 2012. The law includes an important mechanism to help ensure that current and prospective school employees, independent contractors and student teachers are required to provide assurances they have not been previously arrested or convicted of a Section 111(e) offense. Accordingly, under Act 24 of 2011 and Act 82 of 2012, all current and prospective school employees, independent contractors and student teachers are required to complete and return to a designated school administrator a form developed by PDE to report prior arrests or convictions for any offense listed in Section 111(e). On February 16, 2016, Governor Wolf signed into law Act 4, which includes amendments to Section 111 of the school code. Act 4 also includes changes on the PDE-6004 Arrest and Conviction Certification form.
All school employees are required to report to the chief school administrator or the Director of Human Resources within 72 hours of any arrest or conviction of an offense listed in Section 111(e) that occurs after September 28, 2011. The PDE-6004 form shall be used to report these arrests or convictions to the Director of Human Resources; therefore, the PDE-6004 form will always be available to you via this page on the website. The law provides that willful failure to timely report any such arrest or conviction can result in termination of your employment.
The law also requires that if the chief school administrator or the Director of Human Resources has a reasonable belief that an employee was arrested or convicted under a Section 111(e) offense and the employee has not notified the chief school administrator or the Director of Human Resources of such arrest or conviction, the chief school administrator or the Director of Human Resources will require the school employee to submit to a current Section 111 background check. Under these circumstances, the background check shall be at the expense of the employing entity.
Finally, under Section 2070.9(a) of the Professional Educator Discipline Act, the chief school administrator or Director of Human Resources is required to report to the Professional Standards and Practices Commission (PSPC) all instances of employees reporting an arrest or conviction noted on PDE-6004 Arrest and Conviction Certification form.
Reportable Offense List
An offense under one or more of the following provisions of Title 18 of the Pennsylvania Consolidated Statutes:
Chapter 25 (relating to criminal homicide)
Section 2702 (relating to aggravated assault)
Section 2709.1 (relating to stalking)
Section 2901 (relating to kidnapping)
Section 2902 (relating to unlawful restraint)
Section 2910 (relating to luring a child into a motor vehicle or structure)
Section 3121 (relating to rape)
Section 3122.1 (relating to statutory sexual assault)
Section 3123 (relating to involuntary deviate sexual intercourse)
Section 3124.1 (relating to sexual assault)
Section 3124.2 (relating to institutional sexual assault)
Section 3125 (relating to aggravated indecent assault)
Section 3126 (relating to indecent assault)
Section 3127 (relating to indecent exposure)
Section 3129 (relating to sexual intercourse with animal)
Section 4302 (relating to incest)
Section 4303 (relating to concealing death of child)
Section 4304 (relating to endangering welfare of children)
Section 4305 (relating to dealing in infant children)
A felony offense under section 5902(b) (relating to prostitution and related offenses)
Section 5903(c) or (d) (relating to obscene and other sexual materials and performances)
Section 6301(a)(1) (relating to corruption of minors)
Section 6312 (relating to sexual abuse of children)
Section 6318 (relating to unlawful contact with minor)
Section 6319 (relating to solicitation of minors to traffic drugs)
Section 6320 (relating to sexual exploitation of children)
(1) An offense designated as a felony under the act of April 14, 1972 (P.L. 233, No. 64), known as "The Controlled Substance, Drug, Device and Cosmetic Act."
(2) An offense SIMILAR IN NATURE to those crimes listed above in clauses (1) and (2) under the laws or former laws of:
- the United States or one of its territories or possessions; or
- another state; or
- the District of Columbia; or
- the Commonwealth of Puerto Rico; or
- a foreign nation; or
- under a former law of this Commonwealth
A reportable offense enumerated under 24 P.S. §1-111(f.1) consists of any of the following:
- An offense graded as a felony offense of the first, second or third degree, other than one of the offenses enumerated under 24 P.S. §1-111(e), if less than (10) ten years has elapsed from the date of expiration of the sentence for the offense.
- An offense graded as a misdemeanor of the first degree, other than one of the offenses enumerated under 24 P.S. §1-111(e), if less than (5) five years has elapsed from the date of expiration of the sentence for the offense.
- An offense under 75 Pa.C.S. § 3802(a), (b), (c) or (d)(relating to driving under influence of alcohol or controlled substance) graded as a misdemeanor of the first degree under 75 Pa.C.S. § 3803 (relating to grading), if the person has been previously convicted of such an offense and less than (3) three years has elapsed from the date of expiration of the sentence for the most recent offense.