Testimonial of Suitability for Ministryas Priest/Deacon/Religious

(cross out whichever does not apply)

TO:Bishop GeoffreyJarrett

Diocese of Lismore

P O Box 1

LISMORE NSW 2480

FROM:

Name:______

Address: ______

______

Telephone:______

Email:______

This is to verify that Father / Deacon / Brother/ Sister______

______

(full name and date of birth) is a priest / deacon / religious in good standing in the Diocese / Institute of ______who was ordained to the priesthood / diaconate or professed on______at______

After carefully reviewing the personal file and all other records that we maintain, after checking with those who worked with him/her in previous assignments, from my personal knowledge and inaccordance with the requirements of the NATIONAL COMMITTEE FOR PROFESSIONAL STANDARDSdocument Towards Healing paragraph 45.7(see below),and to the best of my knowledge and understanding, I testify that Father / Deacon / Brother / Sister______has

______1.Been a Priest/Deacon/Religious under my jurisdiction and is in good standing

______2.Never been suspended or otherwise canonically disciplined;

______3.No criminal record, nor has been the subject of criminal charges;

______4.Manifested no behavioural problems in the past that would indicate (s)he mightdeal with children, young people, under 18 years, vulnerable adults or others in an inappropriate/immoral manner nor have any allegations ever been made against him/her with respect to such inappropriate behaviour

______5.Never been involved in anything which called into question his/her fitness or

suitability to fulfil the responsibilities and duties of ministry due to alcohol, substance abuse or other causes;

______6.No other particular mental health and physical attribute, condition and/or past

situation which would adversely affect his/her performance of ministry.

If any item is not initialled, please clearly explain details and reason/s on a separate sheet.

Diocesan records indicate and it is my belief that Father/Deacon/Brother/Sister ______

______is of good character and reputation and is qualified to perform their ministry in an effective and suitable manner in the diocese.

Official SealSignature ______

Title ______

Date ______

(Form 45.7)

Relevant Paragraph from #Towards Healing

(January 2010)

45.7 / In these same circumstances the Church Authority in the diocese or institute where the cleric or religious previously lived and worked, shall provide a statement in writing to the new diocese or institute indicating whether such authority knows of any complaints of abuse which have been substantiated or is aware of circumstances that could lead to a complaint of abuse, or whether it considers that there would be an unacceptable risk to children, young people or vulnerable adults if the person were to be allowed to engage in particular kinds of ministry. Where there has been a substantiated complaint, the Church Authority shall furnish all information necessary to evaluate the seriousness of the offence, and shall report on all treatment undertaken, and other measures employed to ensure that further offences do not occur. Such statements shall be held as confidential documents by the Church Authorities.

#as published by The National Committee for Professional Standards, a committee established by the Australian Catholic Bishops’ Conference & the Australian Conference of Leaders of Religious Institutes to oversee the development of policy, principles and procedures in responding to Church-related abuse complaints.

National Committee for Professional Standards PO Box 981 Bondi Junction NSW 1355