Diligent Search Request Form

CLS Atty: ______DILIGENT SEARCH REQUEST FORM

 Original request  Updated Request

Requestor: Case Name:

Date: FSFN Case #:

This request should be initiated and completed by the Child Protective Investigator for the search of missing parents and known relatives per Chapter 39.503, Florida Statutes (F.S.), Administrative Code 65C-30.003 and CFOP 175-22. Upon investigation commencement, CPI shall initiate the search as soon as it is learned that the identity or location is unknown for a parent or prospective parent. Section I – A. Child and Parents’ Demographics (include full name if known (first, middle and last)) Child’s Name: DOB: SSN:

Race: Gender:

Mother’s Name: DOB: SSN:

Mother’s Maiden Race: Name: Primary Language: Place of Birth:

Prospective DOB: SSN: Father’s Name: Father of: Race: Primary Language: Place of Birth:

Section I – B. Additional Information Source Address/Phone Information Obtained

Revised on 4/4/2018 Page 1 of 7 CLS Atty: ______

Section II – Missing Parent Information Name of Missing Relationship to Child(ren): Parent: Aliases: DOB: SSN:

Birthplace: Race: Gender: (State/Country) Height: Weight: Hair Color: Eye Color: Birthmark(s):

Last Known Address: Possible Home/Cell Phone: Past Addresses:

Current or Past Employers: Line of Work:

Criminal Arrests or Probation - List county/state:

Obtain the following information at the shelter hearing or when a dependency petition is filed: F.S. 39.503(1) dictates that the Court conduct inquiry of parent/legal custodian or of any relative/current custodian present at hearing if the identity or location of a parent is unknown OR this information can be provided to the Court via a sworn affidavit by a person having personal knowledge. If this information was obtained through a sworn affidavit you do not need to duplicate this information again. Attach the affidavit to this form. Parent was present at court and information obtained or Parent not in court and CPI to provide information Currently Married? Y or N

Was the mother married at the time of the probable conception and/or at the time of birth? Y or N Was the mother living with a male at the time of the probable conception and/or at the time of birth? Y or N Has the mother named any man as the father on the birth certificate or in connection with applying for or receiving public assistance? Y or N If yes, identify the man’s name: ______Has the mother received payments or promises of support with respect to the child or because of her pregnancy from a man who claims to be the father? Y or N If yes, identify the man’s name: ______Has any man acknowledged or claimed paternity of the child in a jurisdiction in which the mother resided at the time of probable conception and/or since the inception, or in which the child has resided or resides? Y or N If yes, identify the man’s name: ______

Revised on 4/4/2018 Page 2 of 7 CLS Atty: ______Section III – Child/Parents’ Relatives Information Maternal Relatives Relationship to Name Address/Phone Number Information received as to Missing Child(ren) Parent’s Whereabouts Grandmother Grandfather Aunt Uncle Cousin Great-Aunt Half-Sibling

Paternal Relatives Relationship to Name Address/Phone Number Information received as to Missing Child(ren) Parent’s Whereabouts Grandmother Grandfather Aunt Uncle Cousin Great-Aunt Half-Sibling

I, ______, declare that the below efforts were made in a good faith attempt to locate ______, parent of ______, and that his whereabouts remain unknown.

Signature Date

Revised on 4/4/2018 Page 3 of 7 CLS Atty: ______Section IV – Database Search Sources Activity Type Person Subject of Date (date Outcome (actual results) Conducted by Comments /Age the the ncy Searc searc Cont h h acte start d ed) Child Caretaker (Last known address, possible relatives) Child Legal Custodian (Last known address, possible relatives) Computer Search – ACCURINT – (Last known address, possible relatives, or property owned; Zabasearch / White Pages) Court Records (Civil Actions, Divorce Settlements, or restraining orders/Injunction) Criminal/Prison Records – Computer Prison Search (Open or closed supervision address) Criminal/Prison Records – County/Local Jail (Last address reported)

Revised on 4/4/2018 Page 4 of 7 CLS Atty: ______Criminal/Prison Records – FCIC (Last address reported) Criminal/Prison Records – Local Police Dept (Last address reported) Criminal/Prison Records – NCIC (Last address reported) Criminal/Prison Records – Warrants (Last address reported) Friend (Last known address, possible relatives) Local Government – Marriage Records

Local Government – Property Records (Property owned) Local Government – School Records

Parent Present – Information received from another parents (i.e. 2 fathers)

Revised on 4/4/2018 Page 5 of 7 CLS Atty: ______Relative (Last known address, possible relatives) State Agency (Non- Florida) – Children/Family Services (Identified previous residence in other states) State Agency (Non- Florida) – Correction (Open or closed supervision address) State Agency (Non- Florida) – Prison (Open or closed supervision address) State Agency (Non- Florida) – Probation (Open or closed supervision address) State Agency – Dept of Children and Families ACCESS – (Last known address, payment received, date contact made with subject, or names of household occupants) FSFN (Possible contact information including relatives)

Revised on 4/4/2018 Page 6 of 7 CLS Atty: ______State Agency – Dept of Corrections (Open or closed supervision address) State Agency – Dept of Juvenile Justice (Open or closed supervision address) State Agency – Dept of Revenue (Child Support documented address or last home / employment) Vital Statistics – Birth Certificate (Mother and Father’s information)

Revised on 4/4/2018 Page 7 of 7