xmlns:atom="http://www.w3.org/2005/Atom"

SCHEDULE 2

PART IIINFORMATION, DECLARATIONS CERTIFICATE, UNDERTAKINGS AND CONSENTS, TO BE INCLUDED IN AN APPLICATION FOR INCLUSION IN THE SECOND PART OF THE DENTAL LIST

2.  An application shall contain the following declarations as to whether or not the applicant—

(a)has been convicted of a criminal offence in the British Islands or has been convicted elsewhere of an offence which would constitute a criminal offence if committed in the British Islands;

(b)is currently the subject of any proceedings anywhere in the world which might lead to a conviction specified in sub-paragraph (a);

(c)has in summary proceedings in respect of an offence, been the subject of an order discharging the applicant absolutely (without proceeding to conviction);

(d)has accepted and agreed to pay either a fixed penalty under section 302 of the Criminal Procedure (Scotland) Act 1995 or a penalty under section 115A of the Social Security Administration Act 1992;

(e)has accepted a compensation offer under section 302A of the Criminal Procedure (Scotland) Act 1995;

(f)has accepted a combined fixed penalty and compensation offer under section 302B of the Criminal Procedure (Scotland) Act 1995;

(g)has accepted a work order under section 303ZA of the Criminal Procedure (Scotland) Act 1995;

(h)has accepted a police caution in the British Islands;

(i)has been bound over following a criminal conviction in the British Islands;

(j)has been subject to any investigation into the applicant’s professional conduct by any licensing, regulatory or other body anywhere in the world where the outcome was adverse;

(k)is currently subject to any investigation into the applicant’s professional conduct by any licensing, regulatory or other body anywhere in the world;

(l)is the subject of any investigation, proceedings or referral by another Health Board or equivalent body or the Tribunal which might result in the applicant being disqualified, conditionally disqualified, refused entry, granted entry subject to conditions, removed, contingently removed or suspended from a list, or equivalent list;

(m)is, or has been, where the outcome was adverse, the subject of any investigation into the applicant’s professional conduct in respect of any previous or current employment, or, where the applicant is a body corporate, any director of that body corporate has been subject to such;

(n)is, or has in the preceding 6 months been, or was at the time of the events that gave rise to conviction, proceedings, investigation or referral, a director of a body corporate, or a member of a partnership (including a limited liability partnership) which—

(i)has been convicted of a criminal offence in the British Islands;

(ii)has been convicted elsewhere of an offence which would constitute a criminal offence if committed in the British Islands;

(iii)is currently the subject of any proceeding anywhere in the world which might lead to such a conviction;

(iv)has been subject to any investigation into its provision of professional services by any licensing, regulatory or other body anywhere in the world; or

(v)is, to the applicant’s knowledge, or has been, where the outcome was adverse, the subject of any investigation by the Agency or any other body in relation to fraud;

(o)has had sequestration of the applicant’s estate awarded or been adjudged bankrupt;

(p)has been made the subject of a bankruptcy restrictions order or an interim bankruptcy restrictions order under Schedule 4A to the Insolvency Act 1986;

(q)has made a composition or arrangement with, or granted a trust deed for, the applicant’s creditors;

(r)in the case of a body corporate there is a director who is subject to a disqualification order under the Company Directors Disqualification Act 1986, the Companies (Northern Ireland) Order 1986 or to an order made under section 429(2)(b) of the Insolvency Act 1986 (failure to pay under county court administration order).