Get Record Check Consent (form 470-4227) - Ime State Ia

This guide provides clear and detailed instructions on how to effectively fill out the Record Check Consent (Form 470-4227) - Ime State Ia online. By following these steps, users can ensure that all necessary information is accurately provided for the required registry and record checks.

Follow the steps to complete the form accurately.

1. Click ‘Get Form’ button to obtain the form, which will allow you to open it in the online editor.
2. Begin by filling in your personal information. Type or print legibly the following details: your last name, first name, middle name, maiden name (if applicable), and any aliases you may have.
3. Provide your date of birth, gender, and address, including the secondary address line if necessary. Ensure all information is accurate and clearly written.
4. Enter your Social Security Number in the designated format (###-##-####) to assist with the record check process.
5. If applicable, fill in the details regarding your status as an HCBS Waiver Provider (CDAC), including your institution, service area, and reason for the check.
6. Sign and date the form in the designated spaces for each registry check (Sexual Offender Registry, Child Abuse Registry, Dependent Adult Abuse Registry, and Criminal History Record). Ensure that all signatures correspond to the checks you have requested.
7. Once all sections of the form are filled out, you can save your changes, download the completed form, print it, or share it as needed.

Begin your application process by completing the Record Check Consent (Form 470-4227) online today.