Get Indiana Request For A Child Protection Services (cps) History ... - In.gov

This guide provides clear and supportive instructions for completing the Indiana Request For A Child Protection Services History form. Whether you are an individual, organization, or representative, these step-by-step directions will assist you in obtaining crucial child protection history.

Follow the steps to complete your request efficiently.

1. Press the ‘Get Form’ button to access the form and open it for editing.
2. In Section A, fill in the applicant's legal first name, middle name, and last name. Ensure that all spaces are completed and that the names are typed or printed in all capital letters.
3. Choose the reason for the history check by checking all applicable boxes, including options such as foster care, adoption, and employment.
4. Indicate the type of requesting organization by specifying whether it is an agency licensed or subcontracted by the Indiana Department of Child Services or another entity.
5. Provide the name of the contact person within the organization, along with their telephone number, fax number, mailing address, and email address.
6. In Section B, the applicant or their legal representative must provide consent for the information release. This includes signing the form and indicating their relationship to the applicant and the date of signing.
7. Complete the applicant's gender, typed or printed name, date of birth, race, and current residential address.
8. List all Indiana counties where the applicant has resided, and include the dates of residency.
9. Indicate if the applicant has ever used an alias and provide details if applicable, filling in each field for different types of aliases used.
10. In Section C, the designated staff member from the Indiana Department of Child Services will complete specific fields regarding previous foster care applications or records of child abuse.
11. Ensure that all required signatures from both the applicant and the completing staff member are obtained, along with the date and office information.
12. After reviewing the completed form for accuracy, proceed to save your changes, download, print, or share the form as needed.

Complete your document request online today for timely access to child protection history.