Get Ne Consent And Authorization For Release Of Information Form 2014-2025

This guide provides step-by-step instructions for completing the NE Consent And Authorization For Release Of Information Form online. Following these directions will ensure that your submission is accurate and complete.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the applicant's current name, including first, middle, last, and any suffix if applicable.
3. Select the gender by ticking the appropriate option: Male (M) or Female (F).
4. Provide other names that the applicant may have used, such as maiden names, marriage names, or aliases. If there are none, write 'NONE'.
5. Sign and date the form where indicated as the applicant.
6. Enter the applicant's date of birth.
7. If applicable, print the name of the parent or guardian along with their signature and the date signed.
8. Provide a 20-year history of previous addresses, starting with the current address. Include street, city, state, and the dates each address was occupied formatted as mm/yy to mm/yy.
9. Enter the applicant's Social Security Number. Note that this step is voluntary but helps expedite background checks.
10. List the full names and dates of birth of any children the applicant has. If there are no children, write 'NONE'.
11. The licensed child care provider must complete the required sections, including the facility name, phone number, street address, city/state/zip, and child care license number.
12. After filling out all sections of the form, review for completeness and accuracy. Once confirmed, save changes, download, print, or share the completed form as needed.

Complete your NE Consent And Authorization For Release Of Information Form online today for a smooth submission process.