Indiana request for a child protection services form 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin with Section A, where the requesting organization must provide the legal first and last name of the applicant, along with their middle name if applicable. Indicate the reason for the history check by checking all relevant boxes.
3. Fill in the type of requesting organization. If it's an agency, include its name; otherwise, specify 'Other' and provide your organization's name.
4. Complete contact details including the name of a contact person, telephone number, mailing address, fax number, and email address.
5. Move to Section B to be completed by the applicant or their representative. Here, consent for information release must be provided by signing and dating the form.
6. Fill in personal details such as gender, date of birth, race, current residential address, and Social Security number.
7. List all Indiana counties where the applicant has resided along with residency dates. If applicable, detail any aliases used throughout their lifetime.
8. Finally, Section C is for DCS staff only. Ensure that all required fields are completed before submission.

Start using our platform today to fill out your Indiana CPS request form online for free!