Sec. 40.069. REQUIRED AFFIDAVIT FOR APPLICANTS FOR EMPLOYMENT    


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  • (a) An applicant for temporary or permanent employment with the department whose employment or potential employment with the department involves direct interactions with or the opportunity to interact and associate with children must execute and submit the following affidavit with the application for employment:

    STATE OF ____________

    COUNTY OF ____________

    I swear or affirm under penalty of perjury that I do not now and I have not at any time, either as an adult or as a juvenile:

    1. Been convicted of;

    2. Pleaded guilty to (whether or not resulting in a conviction);

    3. Pleaded nolo contendere or no contest to;

    4. Admitted;

    5. Had any judgment or order rendered against me (whether by default or otherwise);

    6. Entered into any settlement of an action or claim of;

    7. Had any license, certification, employment, or volunteer position suspended, revoked, terminated, or adversely affected because of;

    8. Been diagnosed as having or have been treated for any mental or emotional condition arising from;

    9. Resigned under threat of termination of employment or volunteerism for;

    10. Had a report of child abuse or neglect made and substantiated against me for; or

    11. Have any pending criminal charges against me in this or any other jurisdiction for;

    Any conduct, matter, or thing (irrespective of formal name thereof) constituting or involving (whether under criminal or civil law of any jurisdiction):

    1. Any felony;

    2. Rape or other sexual assault;

    3. Physical, sexual, emotional abuse and/or neglect of a minor;

    4. Incest;

    5. Exploitation, including sexual, of a minor;

    6. Sexual misconduct with a minor;

    7. Molestation of a child;

    8. Lewdness or indecent exposure;

    9. Lewd and lascivious behavior;

    10. Obscene or pornographic literature, photographs, or videos;

    11. Assault, battery, or any violent offense involving a minor;

    12. Endangerment of a child;

    13. Any misdemeanor or other offense classification involving a minor or to which a minor was a witness;

    14. Unfitness as a parent or custodian;

    15. Removing children from a state or concealing children in violation of a court order;

    16. Restrictions or limitations on contact or visitation with children or minors;

    17. Any type of child abduction; or,

    18. Similar or related conduct, matters, or things.

    Except the following (list all incidents, location, description, and date) (if none, write NONE):

    Signed________________________

    Date_______________.

    Subscribed and sworn to (or affirmed) before me this ______ day of _________________,_________.

    Signature of notarial officer ______________________________.

    (seal, if any, of notarial officer)

    My commission expires: ___________

    (b) The failure or refusal of the applicant to sign or provide the affidavit constitutes good cause for refusal to hire the applicant.

STATE OF ____________ COUNTY OF ____________ I swear or affirm under penalty of perjury that I do not now and I have not at any time, either as an adult or as a juvenile: 1. Been convicted of; 2. Pleaded guilty to (whether or not resulting in a conviction); 3. Pleaded nolo contendere or no contest to; 4. Admitted; 5. Had any judgment or order rendered against me (whether by default or otherwise); 6. Entered into any settlement of an action or claim of; 7. Had any license, certification, employment, or volunteer position suspended, revoked, terminated, or adversely affected because of; 8. Been diagnosed as having or have been treated for any mental or emotional condition arising from; 9. Resigned under threat of termination of employment or volunteerism for; 10. Had a report of child abuse or neglect made and substantiated against me for; or 11. Have any pending criminal charges against me in this or any other jurisdiction for; Any conduct, matter, or thing (irrespective of formal name thereof) constituting or involving (whether under criminal or civil law of any jurisdiction): 1. Any felony; 2. Rape or other sexual assault; 3. Physical, sexual, emotional abuse and/or neglect of a minor; 4. Incest; 5. Exploitation, including sexual, of a minor; 6. Sexual misconduct with a minor; 7. Molestation of a child; 8. Lewdness or indecent exposure; 9. Lewd and lascivious behavior; 10. Obscene or pornographic literature, photographs, or videos; 11. Assault, battery, or any violent offense involving a minor; 12. Endangerment of a child; 13. Any misdemeanor or other offense classification involving a minor or to which a minor was a witness; 14. Unfitness as a parent or custodian; 15. Removing children from a state or concealing children in violation of a court order; 16. Restrictions or limitations on contact or visitation with children or minors; 17. Any type of child abduction; or, 18. Similar or related conduct, matters, or things. Except the following (list all incidents, location, description, and date) (if none, write NONE): Signed________________________ Date_______________. Subscribed and sworn to (or affirmed) before me this ______ day of _________________,_________. Signature of notarial officer ______________________________. (seal, if any, of notarial officer) My commission expires: ___________ (b) The failure or refusal of the applicant to sign or provide the affidavit constitutes good cause for refusal to hire the applicant. Added by Acts 1997, 75th Leg., ch. 1022, Sec. 22, eff. Sept. 1, 1997.