Appendix B2

EMPLOYEE AFFIDAVIT OF GOOD MORAL CHARACTER

ARCHDIOCESE OF MIAMI

I, ___________________________________, a prospective or current employee, hereby attest, under penalty of perjury to meeting the requirements for volunteering, that I am of good moral character, and that I have not been found guilty of, regardless of adjudication, or entered a plea of nolo contendere or guilty to, any offense (or attempt or conspiracy thereunder) prohibited under any of the following provisions of the Florida Statutes or under any similar statue of a similar jurisdiction. I also attest that I do not have a delinquency record that is similar to any of these offenses.

• Sections 782.04, 782.07, 782.071 and 782.09, relating to murder, manslaughter, aggravated manslaughter of an elderly person or disabled adult, or aggravated manslaughter of a child, vehicular homicide, or killing of an unborn child by injury to the mother;

• Sections 784.021 and 784.045, relating to aggravated battery or aggravated assault, or simple battery or assault of a minor;

• Sections 787.01, 787.02 and 787.04, relating to kidnaping, false imprisonment or removing minors from the state or concealing minors contrary to court order;

• Section 794.011, relating to sexual battery;

• Chapter 796, relating to prostitution;

• Section 798.02 and Chapter 800, relating to lewd and lascivious behavior and indecent exposures;

• Section 806.01, relating to arson;

• Section 826.04, relating to incest;

• Sections 827.03, 827.04, 827.05, and 827.07, relating to child abuse, aggravated child abuse, neglect of a child, negligent treatment of children, contributing to the delinquency or dependency of a child, and sexual performance by a child;

• Chapter 847, relating to obscene literature;

• Section 415.111, relating to adult abuse, neglect or exploitation of aged persons or disabled adults;

• Chapter 893, relating to drug abuse prevention and control, only if the offense was a felony or if another person involved in the offense was a minor;

• Section 817.563, relating to fraudulent sale of controlled substances, only if the offense was a felony;

• Chapter 776, relating to forcible felony;

• Section 784.011, relating to assault, if the victim of the offense was a minor;

• Section 784.03, relating to battery, if the victim of the offense was a minor;

• Former s. 794.041, relating to prohibited acts of persons in familial or custodial authority;

• Sections 825.102, 825.1025, and 825.103 relating to abuse, aggravated abuse, or neglect of an elderly person or disabled adult, lewd or lascivious offenses committed upon or in the presence of an elderly person or disabled adult and exploitation of an elderly person or disabled adult, if the offense was a felony;

• Chapter 812, relating to theft, robbery, and related crimes, if the offense is a felony;

I understand that I must acknowledge the existence of any records relating to the foregoing list of offenses regardless of whether those records have been sealed or expunged. I also understand that I am also obligated to notify my supervisor of any possible disqualifying offenses that may occur while volunteering in a position subject to the screening requirements.

I further attest that:

I have not been judicially determined to have committed abuse, neglect, or exploitation against a child as defined in section 39.01 nor has there been a confirmed report of abuse, neglect or exploitation as defined in 415.105(5) or 415.503, which has been uncontested or upheld pursuant to the procedures of 415.103. I have not committed an act which constitutes domestic violence as defined in 741.30.

I understand that my employment contract is contingent upon background screening. I understand that said screening will include, but not be limited to, employment history checks and statewide criminal correspondence checks through the Florida Department of Law Enforcement, and may include local criminal records checks through local law enforcement agencies. I also understand that the background check may include fingerprinting, statewide criminal and juvenile records checks through the Florida Department of Law Enforcement and federal criminal records checks through the Federal Bureau of Investigation.

Under the penalties of perjury, I declare that I have read the foregoing, and the facts alleged are true to the best of my knowledge and belief.

_______________________________

Affiant

STATE OF FLORIDA )

) SS:

COUNTY OF ________________ )

The foregoing instrument was acknowledged before me this ____ day of _________________, 20____, by _______________________________, [ ] who is personally known to me,

or [ ] who has produced _______________________________ as identification.

_______________________________

NOTARY PUBLIC, State of Florida

Print, type or stamp Notary name:

My Commission Expires:

(Notarization of this form is preferred but not required)