Please make all checks and bmoney ordersb payable to DSS bb - mobar 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling out your personal information in Section I. Include your organization name, requestor’s name, address, email, and telephone number.
  3. In Section IA, if you are a self-requestor or parent, provide your social security number and date of birth along with your contact details.
  4. Indicate your relationship to the individual(s) in Section II. Choose from options like 'Parent of Minor Child' or 'Self' as applicable.
  5. Describe the information you are requesting in Section III. Be specific about time frames and details related to the child abuse and neglect review board if necessary.
  6. Sign and date the form in Section IV to confirm your request.
  7. Complete any additional sections required by county staff on page 2 before submission.

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