Get Cy 104

The Cy 104 form is essential for reporting suspected child abuse to law enforcement officials. This guide provides a clear, step-by-step instruction on how to properly fill out the form online in a comprehensive and user-friendly manner.

Follow the steps to complete the Cy 104 form online.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Begin with the reporting information section. Enter the date the report was received by the county agency, followed by the name of the law enforcement official to whom the report was sent and the date it was sent.
3. Fill out the report sent by section, including the county agency name, address, and the signature of the county agency worker responsible for the report. Provide their phone number for follow-up.
4. Proceed to the identifying information section. Enter the child's name, birthdate, sex, county, and address details.
5. If the child is in a different location than the listed address, provide the current location in the specified area.
6. Complete the sections regarding the mother and father by providing their names, social security numbers, birthdates, telephone numbers, counties, and addresses.
7. Identify the alleged perpetrator using their name, birthdate, telephone number, relationship to the child, and address.
8. Document the city, township, or borough where the abuse occurred.
9. In the reason for referral section, check all applicable boxes regarding the type of abuse suspected, such as homicide, sexual abuse, or serious bodily injury.
10. If there are previous indicated or founded reports, indicate yes, no, or unknown for both the perpetrator and the victim.
11. Include the confidential informant information, ensuring to protect their identity.
12. Finally, provide a narrative describing the nature and extent of the suspected abuse.
13. After completing the form, save your changes. You can then download, print, or share the form as needed to ensure it is sent to the appropriate law enforcement official.

Ensure you follow these steps to submit your Cy 104 form online accurately and efficiently.