Get 470-3301 Authorization For Release Of Child And Dependent Adult ... - Dmgov

The 470-3301 Authorization For Release Of Child And Dependent Adult Abuse Information form is essential for requesting information regarding child or dependent adult abuse when the requester does not have independent access under Iowa law. This guide provides you with clear, step-by-step instructions to effectively navigate and complete this form online.

Follow the steps to complete the authorization form successfully.

1. Click the ‘Get Form’ button to obtain the form and open it in your selected editor.
2. Start by indicating which abuse registry you are requesting information from by checking the appropriate box: 'Both', 'Child Abuse Registry', or 'Dependent Adult Abuse Registry'.
3. Next, specify your preferred method of response by checking a box and providing the required information in Section 1. Options include 'Address', 'Fax', or 'Email'. Make sure to fill out the details accurately.
4. In Section 1, complete the requester details: provide your last name, first name, agency name, address, city, state, zip code, telephone number, fax number, and email address.
5. List the name, date of birth, social security number, and address of the person whose information is being requested. Additionally, include any maiden names, previous married names, or aliases.
6. State the purpose of your request clearly, for example, 'Volunteering with vulnerable populations'.
7. Review the legal provisions section printed on the second page. By signing at the designated area, you confirm your understanding of the legal implications.
8. Have the person authorizing the release of their information sign and date the form in Section 2, confirming their authorization for you to receive the information.
9. Section 3 will be filled out by the Central Abuse Registry or their designee. They will indicate whether the person is listed on the abuse registry and provide any necessary comments.
10. Finally, save your changes, and be prepared to download, print, or share the completed form as required for submission.

Complete your documents online today for a streamlined process.