Rule 1915.3-2. Criminal Record or Abuse History.
(a) Criminal Record or Abuse History Verification. A party must file and serve with the complaint, any petition for modification, any counterclaim, any petition for contempt or any count for custody in a divorce complaint or counterclaim a verification regarding any criminal record or abuse history of that party and anyone living in that party’s household. The verification shall be substantially in the form set forth in subdivision (c) below. The party must attach a blank verification form to a complaint, counterclaim or petition served upon the other party. Although the party served need not file a responsive pleading pursuant to Rule 1915.5, he or she must file with the court a verification regarding his or her own criminal record or abuse history and that of anyone living in his or her household on or before the initial in-person contact with the court (including, but not limited to, a conference with a conference officer or judge or conciliation, depending upon the procedure in the judicial district) but not later than 30 days after service of the complaint or petition. A party’s failure to file a Criminal Record or Abuse History Verification may result in sanctions against that party. Both parties shall file and serve updated verifications five days prior to trial.
(b) Initial Evaluation. At the initial in-person contact with the court, the judge, conference officer, conciliator or other appointed individual shall perform an initial evaluation to determine whether the existence of a criminal or abuse history of either party or a party’s household member poses a threat to the child and whether counseling is necessary. The initial evaluation required by 23 Pa.C.S. § 5329(c) shall not be conducted by a mental health professional. After the initial evaluation, the court may order further evaluation or counseling by a mental health professional if the court determines it is necessary. Consistent with the best interests of the child, the court may enter a temporary custody order on behalf of a party with a criminal history or a party with a household member who has a criminal history, pending the party’s or household member’s evaluation and/or counseling.
Official Note
The court shall consider evidence of criminal record or abusive history presented by the parties. There is no obligation for the court to conduct an independent investigation of the criminal record or abusive history of either party or members of their household. The court should not consider ARD or other diversionary programs. When determining whether a party or household member requires further evaluation or counseling, or whether a party or household member poses a threat to a child, the court should give consideration to the severity of the offense, the age of the offense, whether the victim of the offense was a child or family member and whether the offense involved violence.
(c) Verification. The verification regarding criminal or abuse history shall be substantially in the following form:
(Caption)
CRIMINAL RECORD / ABUSE HISTORY VERIFICATION I
, hereby swear or affirm, subject to penalties of law including 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities that:1. Unless indicated by my checking the box next to a crime below, neither I nor any other member of my household have been convicted or pled guilty or pled no contest or was adjudicated delinquent where the record is publicly available pursuant to the Juvenile Act, 42 Pa.C.S. § 6307 to any of the following crimes in Pennsylvania or a substantially equivalent crime in any other jurisdiction including pending charges:
Check
all that
applyCrime Self Other
household
memberDate of conviction, guilty plea, no contest plea or pending charges Sentence 18 Pa.C.S. Ch. 25 (relating to criminal homicide) 18 Pa.C.S. § 2701 (relating to simple assault) 18 Pa.C.S. § 2702 (relating to aggravated assault) 18 Pa.C.S. § 2705 (relating to recklessly endangering another person) 18 Pa.C.S. § 2706 (relating to terroristic threats) 18 Pa.C.S. § 2709.1 (relating to stalking) 18 Pa.C.S. § 2718 (relating to strangulation) 18 Pa.C.S. § 2901 (relating to kidnapping) 18 Pa.C.S. § 2902 (relating to unlawful restraint) 18 Pa.C.S. § 2903 (relating to false imprisonment) 18 Pa.C.S. § 2904 (relating to interference with custody of children) 18 Pa.C.S. § 2910 (relating to luring a child into a motor vehicle or structure) 18 Pa.C.S. Ch. 30 (relating to human trafficking) 18 Pa.C.S. § 3121 (relating to rape) 18 Pa.C.S. § 3122.1 (relating to statutory sexual assault) 18 Pa.C.S. § 3123 (relating to involuntary deviate sexual intercourse) 18 Pa.C.S. § 3124.1 (relating to sexual assault) 18 Pa.C.S. § 3125 (relating to aggravated indecent assault) 18 Pa.C.S. § 3126 (relating to indecent assault) 18 Pa.C.S. § 3127 (relating to indecent exposure) 18 Pa.C.S. § 3129 (relating to sexual intercourse with animal) 18 Pa.C.S. § 3130 (relating to conduct relating to sex offenders) 18 Pa.C.S. § 3301 (relating to arson and related offenses) 18 Pa.C.S. § 4302 (relating to incest) 18 Pa.C.S. § 4303 (relating to concealing death of child) 18 Pa.C.S. § 4304 (relating to endangering welfare of children) 18 Pa.C.S. § 4305 (relating to dealing in infant children) 18 Pa.C.S. § 5533 (relating to cruelty to animal) 18 Pa.C.S. § 5534 (relating to aggravated cruelty to animal) 18 Pa.C.S. § 5543 (relating to animal fighting) 18 Pa.C.S. § 5544 (relating to possession of animal fighting paraphernalia) 18 Pa.C.S. § 5902(b) or (b)(1) (relating to prostitution and related offenses) 18 Pa.C.S. § 5903(c) or (d) (relating to obscene and other sexual materials and performances) 18 Pa.C.S. § 6301 (relating to corruption of minors) 18 Pa.C.S. § 6312 (relating to sexual abuse of children) 18 Pa.C.S. § 6318 (relating to unlawful contact with minor) 18 Pa.C.S. § 6320 (relating to sexual exploitation of children) 23 Pa.C.S. § 6114 (relating to contempt for violation of protection order or agreement) 
Driving under the influence of drugs or alcohol Manufacture, sale, delivery, holding, offering for sale or possession of any controlled substance or other drug or device
2. Unless indicated by my checking the box next to an item below, neither I nor any other member of my household have a history of violent or abusive conduct, or involvement with a Children & Youth agency, including the following:
Check
all that
applySelf Other
household
memberDate A finding of abuse by a Children & Youth Agency or similar agency in Pennsylvania or similar statute in another jurisdiction Abusive conduct as defined under the Protection from Abuse Act in Pennsylvania or similar statute in another jurisdiction Involvement with a Children & Youth Agency or similar agency in Pennsylvania or another jurisdiction.
Where?:
Other:
3. Please list any evaluation, counseling or other treatment received following conviction or finding of abuse:
4. If any conviction above applies to a household member, not a party, state that person’s name, date of birth and relationship to the child.
5. If you are aware that the other party or members of the other party’s household has or have a criminal record/abuse history, please explain:
I verify that the information above is true and correct to the best of my knowledge, information, or belief. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities.
Signature
Printed Name
Source The provisions of this Rule 1915.3-2 adopted August 1, 2013, effective September 3, 2013, 43 Pa.B. 4702; amended May 14, 2014, effective in 30 days on June 13, 2014, 44 Pa.B. 3233; amended July 20, 2015, effective September 1, 2015, 45 Pa.B. 4158; amended August 9, 2024, effective August 13, 2024, 54 Pa.B. 5353. Immediately preceding text appears at serial pages (402485) and (390555) to (390559).
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