Utica Elementary School



To be a volunteer at a Franklin Area School building or activity, you must have Act 151 and Act 34 clearances (per Franklin Area School Board Policy # 916; the board policy can be viewed at: http://www.fasd.k12.pa.us/site/Default.aspx?PageID=111).

Note: The Pennsylvania Child Abuse History Clearance form has been revised/updated. The previous version of the form (CY 113 12/99) will continue to be accepted for one year from the effective date of this notice, which is April 1, 2012. The revised/updated version of the form is (CY 113 (UF) 6/11). The form number is located in the bottom right hand corner of the form.

The form CANNOT be submitted electronically via email or online. Once the form is completely filled out it must be printed and mailed to:

ChildLine and Abuse Registry
Department of Public Welfare
PO Box 8170
Harrisburg, PA 17105-8170

You can print as many copies of the form as you need. The Department of Public Welfare’s Office of Children, Youth and Families – ChildLine and Abuse Registry will accept copies of the form as long as the applicant’s original signature is on the form when it is mailed in to our office.

1. The instructions for how to complete the Pennsylvania Child Abuse History Clearance form are now included on page three of the form and can be printed for easy reference when completing the form. Failure to comply with the instructions that are attached to the form will cause considerable delay in processing the results.

2. Applicants can now type their information directly onto the form or the form can be printed and the information can be hand written onto the form.

3. If the information is typed directly onto the form, the information will NOT be able to be saved on a computer unless the computer has a licensed version of the acrobat adobe software. Therefore, please be sure to print the completed form before closing the document so that the information typed on the form is not lost.

4. If you have trouble accessing the form you may need to download the latest version of Adobe Reader, which is available free on the internet.

NOTE: ALL information that has been entered directly onto the form will be lost if you close the form prior to printing the form (if your computer does not have a licensed version of the Acrobat Adobe software).

Once the form is received in the ChildLine and Abuse Registry’s Background Check Unit, the results of the Pennsylvania Child Abuse History Clearance will be mailed to the applicant’s address that was noted on the form within 14 days from the date that the clearance is received in that office (right click on the following links to obtain the documents).

CY113 form – English Child Abuse Clearance

CY113 form - Spanish Child Abuse Clearance

For questions related to the Pennsylvania Child Abuse History Clearance, please contact the ChildLine Verification Unit at 717-783-6211 or toll free at 1-877-371-5422.


Below is the link to the Pennsylvania Criminal Record Check form (SP4-164): office (right click on the following link to obtain the documents).

Pennsylvania State Police Request for Criminal record Check Form (SP4-164)

Applicants can also go to the Pennsylvania Access To Criminal History website and apply for their criminal record check online with the Pennsylvania State Police at: office (right click on the following link to obtain the documents).


If you have questions about the Pennsylvania State Police Request for Criminal Record Checks form (SP4 164), please call: (717) 783-9973 or toll free 1-888-783-7972.


Revised:        September 6, 2012


Last Modified on September 7, 2012