Dss form 2924-2025

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The document outlines the Central Registry Release of Information and Compliance Statement required by the South Carolina Department of Social Services for individuals seeking employment or caregiver services at licensed childcare facilities. It details the necessity of a Central Registry check to identify any history of child abuse or neglect, allows for provisional employment under certain conditions, and includes consent for information release. The form requires personal information from the applicant, payment instructions, and provides sections for verification by DSS employees.

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Click ‘Get Form’ to open the dss form 2924 in the editor.
Begin by entering the name of the Child Care Facility and the Director/Operator's name in the designated fields.
Fill in the street address, city, state, zip code, and county of the facility. Ensure all information is accurate for processing.
Select whether you are a new staff member or renewing your application by checking the appropriate box.
Provide your full name (no initials), date of birth, sex, maiden/former name, complete social security number, and race in the specified fields.
List your current address and any previous addresses from the past five years as required.
Sign and date the application at the bottom. Ensure that it is witnessed by the Director/Operator.
Submit payment of $8.00 either by check or online. If paying online, indicate this on the form and provide payment details.

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