Web• Fill out a 3301: Authorization for Dependent Adult Abuse Registry Information 470-3301 o The applicant needs to sign Section 2, and then submit it to the Abuse Registry (fax: 515 … WebDepartment of Public Safety Criminal Records & Identification Bureau located 5700 East Tudor Road Anchorage, Alaska 99507 Department of Health and Social

Form 470 3301 - Fill and Sign Printable Template Online - US …

Web1. Submit a signed copy of the Access to Confidential Abuse Information and Non-Redissemination Agreement (DHS Form 470-3767) along with the SING application, AND 2. Require every employee, who will have access to the CA and DAA Registries, to sign a copy of this same agreement and keep it on file for viewing upon request by the DHS, AND 3. Web470-3301 Authorization for Release of Child and Dependent Adult Abuse Information. 470-3301 (Rev. 12/21) Copy 1: Central Registry Copy 2: Returned to Requester. Iowa … bassani srl

Background Check Consent & Child Abuse Release

Web470-3301 (Rev. 2/16) Copy 1: Central Registry Copy 2: Returned to Requester Iowa Department of Human Services Authorization for Release of Child and Dependent Adult … Web470-3301 (Rev. 2/16) Copy 1: Central Registry Copy 2: Returned to Requester Iowa Department of Human Services Authorization for Release of Child and Dependent … WebForm 470-3301, Authorization for Release of Child and Dependent Adult Abuse Information Every person 14 years of age or older who resides in your home must complete a copy … take a name