Clearance to Publish Children AWOLP on DHS Web

CLEARANCE TO PUBLISH CHILDREN AWOLP ON MDHHS AND NCMEC WEB Michigan Department of Health and Human Services

Instructions: In order to place a child on the Michigan Department of Health and Human Services (MDHHS) and the National Center for Missing and Exploited Children (NCMEC) websites, permission from the person with legal authority to consent is required. If the legal status is Temporary Court Ward-Neglect, written permission from a legal parent is required. If a legal parent is unable to be located or is unwilling to sign, the court of jurisdiction must be petitioned for authority to publish identifying information. If the legal status is State Ward, the written permission of the Michigan Children’s Institute (MCI) Superintendent is required. If the legal status is Permanent Ward of the court, the court provides consent to publish identifying information by signing below.

Youth Name Date of Birth

Gender Age at time of AWOLP

Last Known Placement AWOLP Start Date

Person ID MDHHS Case Number

Case Worker Name Agency

County With Jurisdiction Legal Status

Other name by which youth is known Current Photo Uploaded into MiSACWIS Date

I consent to have my child (or ward in case of legal guardianship) placed on MDHHS public website as well as NCMEC public website for the purpose of locating my missing child. I further agree to allow MDHHS to place my child’s identifying information including a photograph in order to locate my child, who is under the age of 18, on the MDHHS and NCMEC website.

OR Signature of Legal Parent Date Legal Guardian Date

The legal parent of said child is not able to be located or is unwilling to provide permission to place the child on the MDHHS and NCMEC public websites for the purpose of locating the missing child or the child is a permanent court ward. The court consents to MDHHS placing the child’s identifying information, including a photograph in order to locate the child who is under the age of 18, on the MDHHS and NCMEC websites.

Judge Date

I consent to place this child on the MDHHS and NCMEC public websites for the purpose of locating the missing child listed and am within my statutory authority to do so from the Michigan Social Welfare Commission. The Superintendent of MCI is statutorily empowered to make decisions on behalf of a child who is under the age of 18 and has been committed to MCI. MCL 400.203(2). There is a confidentiality provision within the statute which states in relevant part: All records pertaining to any child committed to said institute shall be filed as confidential and shall not be made public thereafter excepting as the said commission shall authorize, when deemed necessary for the best interest of the child. MCL 400.211.

Michigan Children’s Institute Superintendent Date

To be filled out by the AWOLP Child Locator Analyst Date Entered on Website Date Located Date Removed from Website

DHS-710 (Rev. 11-15) Previous edition obsolete.