We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Multi-State Forms
  • Pa Pde-6004 2016

Get Pa Pde-6004 2016-2025

1 of 3 ARREST/CONVICTION REPORT AND CERTIFICATION FORM (under Act 24 of 2011 and Act 82 of 2012) Section 1. Personal Information Full Legal Name: Date of Birth: / / Other names by which you have been.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the PA PDE-6004 online

Filling out the PA PDE-6004 form online is an essential step for current and prospective employees of educational institutions in Pennsylvania. This guide will provide detailed instructions for completing each section of the form, ensuring you provide the necessary information accurately.

Follow the steps to complete the form accurately and efficiently.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. In Section 1, provide your personal information, including your full legal name and date of birth. If you have any other names you have been identified by, include them as well.
  3. Move to Section 2 regarding arrests or convictions. Check the appropriate box to indicate whether you have NOT been arrested for or convicted of any reportable offense or if you have. If you have, detail each arrest or conviction including the offense, date, location, docket number, and applicable court.
  4. In Section 3, indicate if you have NOT been named as a perpetrator of a founded report of child abuse in the last five years or if you have. Check the corresponding box based on your situation.
  5. In Section 4, review the certification statement. By signing this form, you affirm that all provided information is true, correct, and complete. Be sure to include your signature and the date.
  6. Once all sections are completed, review your information for accuracy. You can then save changes, download the form, print it, or share it as needed.

Complete the PA PDE-6004 form online today to ensure your application process is smooth and compliant.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

ARREST/CONVICTION REPORT AND CERTIFICATION FORM
Mar 1, 2016 — 4) and (j), the Pennsylvania Department of Education developed this...
Learn more
ARREST/CONVICTION REPORT AND CERTIFICATION FORM
Mar 1, 2016 — 4) and (j), the Pennsylvania Department of Education developed this...
Learn more
Proceedings of the CleanUp Conference 2015...
Sept 13, 2015 — In situ Smoldering Combustion (STAR) Pre-Design Evaluation (PDE) for...
Learn more

Related links form

Community Property Sample 2020 Agents Signature 2020 Hudson County New Jersey Naturalization Papers 2020 Geotechnical Risk Management Policy For Bb - Pittwater Council - Pittwater Nsw Gov 2020

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

Act 24 of 2011 (Act 24) amends Section 111 of the School Code, which provides for background checks for employees of public and private schools, intermediate units and area vocational-technical schools. The changes to Section 111 became effective on September 28, 2011.

Required Legal Clearances. Act 24 requires all current and future employees/pre-service teachers to complete a Pennsylvania Department of Education (PDE) form to report prior arrests or convictions for any offenses listed on form PDE-6004.

How long are clearances good for in PA schools? The PA Criminal History clearance is valid for one year from issuance date.

The required clearances may include: Pennsylvania Child Abuse History Clearance. Pennsylvania State Police Criminal History Clearance. Federal Bureau of Investigations (FBI) Criminal History Clearance. (required for all employees and some volunteers)

Act 24, which lowered Pennsylvania's legal limit of alcohol from . 10 to . 08, was signed into law on September 30, 2003.

​Act 24: Reporting Arrests and Convictions Additionally, Act 24 requires that all school employees complete and return to their school administrator a PDE Form 6004 (PDF) within 72 hours of any arrest or conviction of an offense listed in Section 111(e).

Section 111 requires that the school administrator or other person responsible for employment decisions in a school entity review the background check reports and determine whether prospective employees, contractors, or their employees are barred from positions in which they will have contact with children before ...

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get PA PDE-6004
Get form
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232