Get Fillable Form 470 0643

The Fillable Form 470 0643 is used to request information regarding child and dependent adult abuse reports. This guide will provide you with clear, step-by-step instructions to effectively fill out the form online, ensuring your request is submitted accurately and efficiently.

Follow the steps to fill out the Fillable Form 470 0643 online

1. Click the ‘Get Form’ button to access the Fillable Form 470 0643 and open it in your preferred online form editor.
2. In the form, specify the type of request by checking the appropriate box for either a child abuse request, a dependent adult abuse request, or both.
3. Indicate your preferred method of response by checking the corresponding box and completing the information in Section 1. This includes your address, email, and telephone number.
4. In Section 1, fill out your details as the requester, including your last and first name, agency name (if applicable), relationship to the person(s) listed, and the purpose for your request.
5. State the Iowa Code section that allows access to the child or dependent adult abuse information you are requesting, and ensure you understand the legal provisions regarding this information handling.
6. Sign and date the request to confirm that you have authorized access to the information.
7. Complete Section 2 if the purpose of your request relates to employment, licensing, or other approvals. Here, list the name and address of the person whose record is being checked, including their birth date and social security number.
8. Section 3 should be filled out if you seek a summary of the abuse investigation or assessment. List the names and details of the individuals for whom you are requesting information.
9. Section 4 will include the decision from the registry or its designee, indicating if your request is approved or denied, along with the signature and date.
10. Once the form is complete, you can save your changes, download, print, or share the form as needed.

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