Ohio Criminal Check Form
  • Ohio Criminal Check Form

  • 959.13 Cruelty to animals
    959.131 Prohibitions concerning companion animals
    2903.01 Aggravated murder
    2903.02 Murder
    2903.03 Voluntary manslaughter
    2903.04 Involuntary manslaughter
    2903.041 Reckless homicide
    2903.11 Felonious assault
    2903.12 Aggravated assault
    2903.13 Assault
    2903.15 Permitting child abuse
    2903.16 Failing to provide for a functionally impaired
    person
    2903.21 Aggravated menacing
    2903.211 Menacing by stalking
    2903.22 Menacing
    2903.34 Patient abuse; neglect
    2903.341 Patient endangerment
    2905.01 Kidnapping
    2905.02 Abduction
    2905.04 Child stealing
    2905.05 Criminal child enticement
    2905.11 Extortion
    2905.12 Coercion
    2905.32 Trafficking in persons
    2905.33 Unlawful conduct with respect to documents
    2907.02 Rape
    2907.03 Sexual battery
    2907.04 Unlawful sexual conduct with a minor,
    formerly corruption of a minor
    2907.05 Gross sexual imposition
    2907.06 Sexual imposition
    2907.07 Importuning
    2907.08 Voyeurism
    2907.09 Public indecency
    2907.12 Felonious sexual penetration
    2907.21 Compelling prostitution
    2907.22 Promoting prostitution
    2907.23 Procuring
    2907.24 Soliciting & solicitation after a positive HIV
    test
    2907.25 Prostitution
    2907.31 Disseminating matter harmful to juveniles
    2907.32 Pandering obscenity
    2907.321 Pandering obscenity involving a minor
    2907.323 Illegal use of a minor in nudity-oriented
    material or performance
    2907.33 Deception to obtain matter harmful to
    juveniles
    2909.02 Aggravated arson
    2909.03 Arson
    2909.04 Disrupting public services
    2909.22 Soliciting or providing support for act of
    terrorism
    2909.23 Making terroristic threat
    2909.24 Terrorism
    2911.01 Aggravated robbery
    2911.02 Robbery
    2911.11 Aggravated burglary
    2911.12 Burglary
    2911.13 Breaking & entering
    2913.02 Theft
    2913.03 Unauthorized use of a vehicle
    2913.04 Unauthorized use of property, computer,
    cable, or telecommunication property
    2913.05 Telecommunications fraud
    2913.11 Passing bad checks
    2913.21 Misuse of credit cards
    2913.31 Forgery; identification card
    2913.32 Criminal simulation
    2913.40 Medicaid fraud
    2913.41 defrauding a rental agency or hostelry
    2913.42 Tampering with records
    2913.43 Securing writings by deception
    2913.44 Personating an officer
    2913.441 Unlawful display of law enforcement
    emblem
    2913.45 Defrauding creditors
    2913.46 Illegal use of supplemental nutrition
    assistance program or women, infants, and
    children program benefits
    2913.47 Insurance fraud
    2913.48 Worker’s compensation fraud
    2913.49 Identify fraud
    2913.51 Receiving stolen property
    2917.01 Inciting to violence
    2917.02 Aggravated riot
    2917.03 Riot
    2917.31 Inducing panic
    2919.12 Unlawful abortion
    2919.121 Unlawful abortion on a minor
    2919.123 Unlawful distribution of an abortioninducing drug
    2919.22 Endangering children
    2919.23 Interference with custody
    2919.24 Contributing to unruliness or delinquency of
    a child
    2919.25 Domestic violence
    2921.03 Intimidation
    2921.11 Perjury
    2921.12 Tampering with evidence
    2921.13 Falsification, falsification in theft offense,
    falsification to purchase firearm, or
    falsification to obtain a concealed handgun
    2921.21 Compounding a crime
    2921.24 Disclosure of confidential information
    2921.32 Obstructing justice
    2921.321 Assaulting/harassing police dog or
    horse/service animal
    2921.34 Escape
    2921.35 Aiding escape or resistance to authority

    2921.36 Illegal conveyance of weapons, drugs, or
    other prohibited items onto grounds of
    detention facility or institution
    2921.51 Impersonation of peace officer
    2923.12 Carrying concealed weapons
    2923.122 Illegal conveyance or possession of a deadly
    weapon or dangerous ordnance in a school
    safety zone & illegal possession of an object
    indistinguishable from a firearm in a school
    safety zone.
    2923.123 Illegal conveyance or possession of a deadly
    weapon or dangerous ordnance in a
    courthouse & illegal possession of deadly
    weapon or dangerous ordnance in a
    courthouse.
    2923.13 Having weapons while under disability
    2923.161 Improperly discharging a firearm at or into a
    habitation or school
    2923.162 Discharge of firearm on or near prohibited
    premises
    2923.21 Improperly furnishing firearms to a minor
    2923.32 Engaging in a pattern of corrupt activity
    2923.42 Criminal gang activity
    2925.02 Corrupting another with drugs
    2925.03 Trafficking in drugs
    2925.04 Illegal manufacture of drugs or cultivation of
    marijuana
    2925.041 Illegal assembly or possession of chemicals
    for the manufacture of drugs
    2925.05 Funding of drugs or marijuana trafficking
    2925.06 Illegal administration or distribution of
    anabolic steroids
    2925.09 Illegal administration, dispensing,
    distribution, manufacture, possession,
    selling, or using any dangerous veterinary
    drug
    2925.11 Drug possession other than a minor drug
    possession offense
    2925.13 Permitting drug abuse
    2925.22 Deception to obtain a dangerous drug
    2925.23 Illegal processing of drug documents
    2925.24 Tampering with drugs
    2925.36 Illegal dispensing of drug samples
    2925.55 Unlawful purchase or receipt of
    pseudoephedrine product
    2925.56 Unlawful sale of pseudoephedrine product
    2927.12 Ethnic intimidation
    3716.11 Placing harmful objects in food or confection

    A conviction of conspiracy, attempt, or
    complicity that relates to a crime listed on
    this document may also be an employment
    disqualifier

     

  • ADDITIONAL DISQUALIFYING OFFENSES: A felony in the Revised Code that is not one of the offenses included in this list that bears a direct and substantial
    relationship to the duties and responsibilities of the position being filled. Any offense in the Revised Code that constitutes a misdemeanor of the first degree on the first
    offense and a felony on a subsequent offense and bears a direct and substantial relationship to the position being filled and the nature of the services provided by
    ODODD or a county DD board. A violation of an existing or former municipal ordinance or law of this state, any other state, or the United States that is substantially equivalent to any of the offenses listed above.

    PLEASE REVIEW THE ABOVE LIST OF CRIMINAL OFFENSES AND READ AND COMPLETE THE FOLLOWING DECLARATION STATEMENT:

    I, (print name)

  • hereby declare that I have never been convicted of or pleaded guilty
    to any of the criminal offenses listed above. I also understand that if I am charged with any of the above-listed offenses, either during the application process or during the course of my employment at A-Plus Home Health Agency, LLC, I must report the charge to the Administrator or his or her designee no later than the next scheduled business day. I also understand that I could be fingerprinted periodically during my employment as required by either State Law or Rule.

    I further understand that my employment may be terminated for failure to disclose any relevant violations. I understand that the Administrator or his or her designee is relying on the accuracy of these statements and that this information is a condition of employment. Therefore, I hereby declare that the above statements are complete, true, and accurate under penalty of perjury.

  • Date
     - -
  •  
  • Should be Empty: