Ldss 3370 fillable form-2026

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The document LDSS-3370 provides detailed instructions for completing the Statewide Central Register Database Check Form, which is required for screening individuals involved in adoption, foster care, and daycare services in New York State. It outlines the necessary information to be filled out regarding agency details, applicant and household member information, address history, and signature requirements. The form must be legible and complete to avoid being returned for corrections. Additionally, it specifies the categories of individuals who need to be screened and includes instructions for submitting the form.

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Click ‘Get Form’ to open the Ldss 3370 fillable form in the editor.
Begin by entering the three-digit agency code in the top left box, followed by the Resource I.D. (RID) and Child Care Facility System (CCFS) Number if applicable.
Fill in the clearance category letter code and provide a contact phone number for your agency liaison.
In the Agency Address area, type the full name of your agency, along with the liaison's name and complete address.
For Applicant Information, list all household members clearly, starting with the applicant’s name followed by any maiden names or aliases. Ensure to indicate their relationship to the applicant.
Complete the address history section accurately, providing addresses from January 1973 or from when each individual turned 18. Attach additional pages if necessary.
Finally, ensure all required signatures are obtained and dated appropriately before submitting your completed form.

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Versions	Form popularity	Fillable & printable
2011	4.9 Satisfied (431 Votes)
2009	4.3 Satisfied (159 Votes)
2007	4 Satisfied (49 Votes)
2003	4.3 Satisfied (169 Votes)

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What is a SCR form?

State Central Register Database Check Form Each SCR Database Check form submitted should be reviewed for completeness and legibility by the camp program. If the form is incomplete or illegible, it will be returned to you for corrections.

What is the LDSS 3370 form used for?

The purpose of collecting the demographic data on other persons in your household who are not screened pursuant to Section 424-a of the Social Services Law is to enable the NYS Office of Children and Family Services to identify with the greatest degree of certainty whether the person(s) being screened is the subject of ...