On from the Nebraska Adult / Child Abuse and Neglect Central Registry. If you are under the age of 19, a parent or guardian s notarized signature is required instead of yours. Do not leave any fields blank. This notary form is valid for 6 months. Request Number: INDIVIDUAL INFORMATION Name: Date of Birth: Printed Name of Person Signing (must be legible): Individual or Individual s Guardian Signature of Individual / Guardian:.

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How to fill out the NE CFS-400 online

The NE CFS-400 form is essential for verifying the identity of individuals requesting information from the Nebraska Adult/Child Abuse and Neglect Central Registry. This guide provides clear instructions on how to fill out the form accurately online.

Follow the steps to complete the NE CFS-400 online.

  1. Click 'Get Form' button to access the NE CFS-400 and open it in the editor.
  2. In the 'Request Number' field, enter your unique request number provided for the verification process.
  3. Fill in the 'Individual Information' section with the following details: enter your full name in the designated field.
  4. Provide your date of birth in the 'Date of Birth' field using the format MM/DD/YYYY.
  5. In the 'Printed Name of Person Signing' section, ensure your name is written legibly. If the form is being signed by a guardian, enter the guardian's name.
  6. Select the appropriate checkbox indicating whether you are the individual or the individual's guardian.
  7. Sign the form in the 'Signature of Individual / Guardian' field and include the date of the signature.
  8. In the 'Notary Use Only' section, prepare for notarization by providing the state and county where the notarization will occur.
  9. Ensure the notary public acknowledges your signature by entering the date of acknowledgment and affixing the official notary seal.
  10. Once the form is fully completed and notarized, do not mail it. Instead, upload and attach this document to your Check Request on the Nebraska Central Registry Portal.
  11. To access your Check Request, enter the PIN you created and the Request Number on the portal.

Complete your NE CFS-400 online today for timely processing.

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What is the Nebraska Central Registry?

​Child Abuse and Neglect Central Registry Maintains all reports of child abuse and neglect opened for investigation, classified as either Court Substantiated or Agency Substantiated.

'Child abuse or neglect' means knowingly, intentionally, or negligently causing or permitting a minor child to be deprived of necessary food, clothing, shelter, or care or causing or permitting a child aged 6 or younger to be left unattended in a motor vehicle.

Stat. 28-718 and 28-376) states the Department of Health and Human Services (DHHS) must keep records of persons who DHHS or the courts find responsible for abuse and neglect of a child or vulnerable adult. DHHS maintains these records in the Nebraska Adult and Child Abuse and Neglect Central Registry. Abuse and Neglect Central Registry - DHHS - Nebraska.gov DHHS - Nebraska.gov https://dhhs.ne.gov › pages › abuse-and-neglect-central-r... DHHS - Nebraska.gov https://dhhs.ne.gov › pages › abuse-and-neglect-central-r...

Written reports must include, to the extent available: The address and age of the child; The address of the person(s) having custody of the child; The nature and extent of the abuse or neglect, or conditions and circumstances which would reasonably result in such child abuse or neglect; Any evidence of previous child ...

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