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Begin with Section 1, providing your Central Registry information. Ensure all required fields are filled accurately to avoid delays.
In Section 2, enter your personal details including your name, address, Social Security Number, and date of birth. Double-check for any missing information.
Proceed to Section 3 where you must sign the form in front of a Notary Public. This signature confirms the accuracy of the information provided.
If applicable, complete Section 4 by indicating the purpose of your request and any designees in Section 5 who should receive the results.
Finally, review all sections for completeness before submitting via email, fax, or mail as instructed at the end of the form.
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