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G17. Embezzlement(theft of money or other valuables entrusted to you). (MARK ALL THAT APPLY) <br /> a. I have committed it <br /> b. I have been arrested for it <br /> c. I have been tried in court for it <br /> d. I have been convicted of it, or pleaded guilty or no contest <br /> e. None of the above <br /> G18. A forcible sex act or rape. (MARK ALL THAT APPLY) <br /> a. I have committed it <br /> b. I have been arrested for it <br /> c. I have been tried in court for it <br /> d. I have been convicted of it, or pleaded guilty or no contest <br /> e. None of the above <br /> G19. Sexually abusing or molesting a child. (MARK ALL THAT APPLY) <br /> a. I have committed it <br /> b. I have been arrested for it <br /> c. I have been tried in court for it <br /> d. I have been convicted of it, or pleaded guilty or no contest <br /> e. None of the above <br /> G20. Causing harm to others (such as assault, resisting arrest,or battery). (MARK ALL THAT <br /> APPLY) <br /> a. I have committed it <br /> b. I have been arrested for it <br /> c. I have been tried in court for it <br /> d. I have been convicted of it, or pleaded guilty or no contest <br /> e. None of the above <br /> G21. Theft of property(such as burglary, stealing, or breaking and entering) (MARK ALL THAT <br /> APPLY) <br /> a. I have committed it <br /> b. I have been arrested for it <br /> c. I have been tried in court for it <br /> d. I have been convicted of it, or pleaded guilty or no contest <br /> e. None of the above <br /> G22. Vandalism or malicious mischief. (MARK ALL THAT APPLY) <br /> a. I have committed it <br /> b. I have been arrested for it <br /> c. I have been tried in court for it <br /> d. I have been convicted of it, or pleaded guilty or no contest <br /> e. None of the above <br /> G23. A sexual crime, other than rape or child molesting (such as self-exposure, obscene phone <br /> calls, peeping torn) (MARK ALL THAT APPLY) <br /> a. I have committed it <br /> b. I have been arrested for it <br /> c. I have been tried in court for it <br /> d. I have been convicted of it, or pleaded guilty or no contest <br /> e. None of the above <br /> PSS/LEPS PLLC 75 <br />