Form Cc-201 - Certification Statement For Providing Child Care Services (Page 2 of 5) in pdf

CC-201 (8-14) - Page 2

Previous versions not accepted

Non-Appealable Offenses

Are you awaiting trial for or have you ever been convicted of committing, attempting to commit, soliciting or facilitating or conspiring to

commit one or more of these crimes in this state or a similar crime in another jurisdiction? Mark “Yes” or “No” as applicable.

If you are subject to registration as a sex offender in this state or any other jurisdiction, or awaiting trial on or been convicted of committing,

attempting to commit, soliciting or facilitating, or conspiring to commit one or more of the crimes in this section DPS will deny you a Level 1

Fingerprint Clearance Card and you WILL NOT be eligible to appeal the decision.

Expunged convictions from any court other than juvenile court must be identified.

YES

1. Sexual abuse of vulnerable adult

2. Incest

3. Homicide, including first or second-degree murder, manslaughter and negligent homicide

4. Sexual assault

5. Sexual exploitation of a minor or vulnerable adult

6. Commercial sexual exploitation of a minor or vulnerable adult

7. Child prostitution as prescribed in A.R.S. § 13-3212

8. Child abuse

9. Felony child neglect

10. Sexual conduct with a minor

11. Molestation of a child or vulnerable adult

12. Dangerous crime against children as defined in A.R.S. § 13-705

13. Exploitation of minors involving drug offenses

14. Taking a child for the purposes of prostitution as defined in A.R.S. § 13-3206

15. Neglect or abuse of a vulnerable adult

16. Sex trafficking

17. Sexual abuse

18. Production, publication, sale, possession and presentation of obscene items as prescribed in A.R.S. § 13-3506

19. Furnishing harmful items to minors as prescribed in A.R.S. § 13-3506

20. Furnishing harmful items to minors by internet activity as prescribed in A.R.S. § 13-3506.01

21. Obscene or indecent telephone communications to minors for commercial purposes as prescribed in

A.R.S. § 13-3512

22. Luring a minor for sexual exploitation

23. Enticement of persons for purposes of prostitution

24. Procurement by false pretenses of persons for purposes of prostitution

25. Procuring or placing persons in a house of prostitution

26. Receiving earnings of a prostitute

27. Causing one’s spouse to become a prostitute

28. Detention of persons in a house of prostitution for debt

29. Keeping or residing in a house of prostitution or employment in prostitution

30. Pandering

31. Trafficking of persons for forced labor or services as defined in A.R.S. § 13-1308

32. Transporting persons for the purpose of prostitution, polygamy and concubinage

33. Portraying adult as a minor as prescribed in A.R.S. § 13-3555

34. Admitting minors to public displays of sexual conduct as prescribed in A.R.S. § 13-3558

35. Any felony offense involving contributing to the delinquency of a minor

36. Unlawful sale or purchase of children

37. Child bigamy

38. Any felony offense involving domestic violence as defined in A.R.S. § 13-3601, except for a felony offense only

involving criminal damage in an amount more than $250, but less than $1000 if the offense was committed before

June 29, 2009.

39. Felony indecent exposure

40. Felony public sexual indecency

41. Felony driving under the influence, driving under the extreme influence or aggravated driving under the influence if

committed within 5 years of the date you apply for a Level 1 Clearance Card.

42. Terrorism

43. Any offense involving a violent crime as defined in A.R.S. § 13-901.03

Form Cc-201 - Certification Statement For Providing Child Care Services Page 2

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