Department of Family and Children S Services s1

Santa Clara County Social Services Agency Department of Family and Children’s Services REQUEST FOR LOCATION SERVICES

INSTRUCTIONS: Use one form for each subject to be located. Complete and forward to the: DFCS Receiving, Assessment, and Intake Center (RAIC). Pony: RAIC, 725 E. Santa Clara, San Jose CA 95112 ~ Email: [email protected] Attention: AIC Supervisor Fill in all blanks or write “N/A” for not applicable or “UNK” for unknown

Date Submitted to the RAIC: Case Name: Date Received by RAIC: DFCS Case #: Reason for Request: Paternity Jurisdiction/Disposition Review Hearing 366.26 Hearing Other

Publication for 366.26 Hearing? No Yes If yes, results or status report must be submitted to social worker within 30 days of receipt of this request Date of 366.26 Hearing:

Child(ren)’s Name DOB Petition # Place of Birth

PERSON TO BE LOCATED: Name: AKA: Date of Birth Place of Birth: Social Security #: Driver’s License # : State: Previous Search Request: Unknown No Yes If Yes, date of last results: Distinguishing Marks Last Known Address: Previous Address: When was subject last seen? By Whom: Where was subject last seen? Has subject been incarcerated: No Yes If Yes, When? Where? Last Known Employer: Address: Employer’s Telephone: Job Title: Date Employed: Name(s) of the Other parent(s):

SCZ659 Filing: 3rd Fastener, 3rd Divider, Under Request for Location Services – 3/10/15

of 2 Relatives of Subject:

Name: Relationship: Address: Telephone:

Social Worker’s Preliminary Search Activities These are minimal search activities prerequisite to requesting location services.

Activities Date Results

County Jail State Prisoner/Parolee ID County Probation Other Parent(s) Subject’s Relatives CWS/CMS Local Telephone Directory* (*For area(s) where subject has lived.) Other information, which may assist in locating the subject:

Submitted by:

Social Worker’s Name (Please Print) S.W. # Telephone # Email

SCZ659 Filing: 3rd Fastener, 3rd Divider, Under Request for Location Services – 3/10/15