Form 470 3301-2026

1. Click ‘Get Form’ to open it in the editor.
2. In Part A, fill in your details as the requester. Include your name, address, city, state, zip code, phone number, birth date, and social security number.
3. Provide the information concerning the individual by entering their name (first, middle initial, last), maiden name or alias if applicable, and their address details.
4. State the purpose of your request for child abuse information clearly in the designated field.
5. Read and acknowledge the legal provisions by signing and dating the form at the bottom of Part A.
6. In Part B, ensure that the person authorizing the release of information signs and dates this section.
7. Part C will be completed by the Central Abuse Registry. Ensure all sections are filled out correctly before submission.

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