Get Cc13 06-3922 Release To Review Background Information - Dpaweb - Dpaweb Hss State Ak

The CC13 06-3922 Release To Review Background Information form is essential for individuals seeking to provide care for children in a licensed facility in Alaska. This guide provides clear and structured steps to complete the form accurately online, ensuring a smooth process for users of all backgrounds.

Follow the steps to fill out the form correctly.

1. Press the ‘Get Form’ button to access the form and open it in an online editor.
2. Begin by entering your last name, first name, and middle name in the designated fields to identify yourself.
3. Provide your street address, city, and zip code to accurately document your residence.
4. Indicate the name of the facility where you will be working or volunteering.
5. Specify your Alaska residency status. If you have lived in Alaska for less than 12 months, input the number of years and months you have resided here and provide your last state of residence.
6. Enter your date of birth in the appropriate section to confirm your age.
7. Select your gender by checking the appropriate box.
8. Fill in your Social Security number to verify your identity.
9. Document any aliases or previous names you may have used, including maiden names.
10. Input your driver's license number and the state of issuance to further identify yourself.
11. Answer the questions regarding your previous licenses and any history of investigations or offenses by selecting ‘Yes’ or ‘No’ as appropriate. Provide additional details on a separate page if needed.
12. Review and authorize the licensing representative to check your criminal justice, juvenile justice, and protective service records.
13. Sign and date the form before submission. If you are 16 or 17 years old, ensure that a parent or guardian also signs.
14. After completing the form, you can save changes, download a copy for your records, print it, or share it as needed.

Take the next step in your journey to provide care for children by filling out the CC13 06-3922 form online today.