Follow the steps to complete the form accurately and efficiently.

1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
2. Begin by filling in your personal information in Section 1. This includes your last name, first name, middle initial, and Social Security or ITIN number. Only indicate 'Related to child' if applicable to all children in care; otherwise, select 'Not related to child'.
3. In Section 2, select your type of care from the options available. Ensure you only check one: License Exempt Center Employee, Home Exempt from Licensing, Relative Home Exempt from Licensing, Non-Relative in Home of Child, or Relative in Home of Child.
4. Complete Section 3 with your current address, telephone number, date of birth, place of birth, citizenship details, and personal characteristics, such as height, weight, hair color, eye color, skin tone, and race.
5. Answer the questions regarding prior child abuse investigations and criminal convictions accurately. Your responses must be truthful.
6. Review the Authorization/Certification statement. Ensure you understand this section before signing and dating the form.
7. After filling out all sections, save any changes you have made to the form. You can then download a copy, print it, or share it as necessary.

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