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470 0643 form-2026
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- Click ‘Get Form’ to open the 470 0643 form in the editor.
- Begin by selecting your type of request at the top of the form. Check the appropriate box for either 'Child abuse request', 'Dependent adult abuse request', or 'Both'.
- In Section 1, fill in your details as the requester. Include your last name, first name, agency name, telephone number, address, fax number, email, and your relationship to the individuals listed in Sections 2 or 3.
- Specify the purpose of your request and state the Iowa Code section that allows access to this information. Ensure you read and understand the legal provisions before signing and dating the form.
- If applicable, complete Section 2 with details about the person whose record is being checked. Provide their full name, address, birth date, social security number, and any previous names.
- For requests regarding a written summary of an investigation (Section 3), list all relevant names and addresses. Attach additional pages if necessary.
- Finally, review all sections for accuracy before submitting via email or fax as indicated on the form.
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