Mation on this form, and responses generated as a result of this form, are confidential. Any person disclosing the information in violation of 43.540, 589.400, RSMo. and /or 210.150 RSMo. is guilty of a class A misdemeanor. For information on how to participate in the Child Abuse/Neglect Central Registry examination program, submit a written request from the CEO, owner, director, etc. of your child care related group or organization to: Director, Division of Family Services, P.O. Box 88, Jeffers.
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How to fill out the MO Form 821-0353 online
Filling out the MO Form 821-0353 online is an essential step for individuals seeking to request child abuse or neglect and criminal record information. This guide provides clear instructions to help you complete the form efficiently and accurately.
Follow the steps to successfully complete the MO Form 821-0353.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Select the type of service you require by checking only one box. The options include Name Search, Fingerprint Search, or DFS Central Registry Child Abuse Search. Ensure that you understand the services offered before making your selection.
- Provide the identifying data as required. This includes the applicant's name, maiden name, date of birth, alias names, state of birth, social security number, sex, race, and driver's license number. Make sure to use legible characters.
- Complete the addresses section by listing all previous addresses for the past five years. Include street, city, and state for each address.
- Indicate if you have ever been found guilty or convicted of any criminal act. If yes, complete the additional section, providing details about the offense.
- Indicate if you have ever been substantiated as a perpetrator in any child abuse or neglect report. If yes, fill out the corresponding section with the necessary details.
- Sign the form where indicated, ensuring your signature is in ink. The applicant must also complete the date field next to their signature.
- If applicable, the requestor should also sign and date the form in ink. Include information about the child care provider and their contact details.
- Complete the return address section to ensure proper processing of your request. This should include agency name, attention, address, city, state, and zip code.
- Once you have filled out all sections, review the form for accuracy. After confirming all information is correct, save your changes, then download, print, or share the completed form as needed.
Complete your MO Form 821-0353 online to ensure timely processing of your request.
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the purpose of this form is to provide information available to child care agencies...
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