ORIGINAL DCS FORM/ ACCEPTS 3RD PICT FOR PREFERRED RESPONS ADDITIONAL STATE CONTACT INFO EMAIL ADDRESS OWN FORM? NOTARY? SIGNATURE FEE? FEE INFO LETTERHEAD PARTY ID? EMPLOYMENT? TRANSMITTAL E TIME COMMENTS ? REQUIRED? REQUESTS? Additional contacts: Alabama State Jon Perdue, Phone: (334) Department of Human Program 242-9500 Fax: jon.perdue@d Resources, Family Manager (334) 242-0939 hr.alabama.gov Services Division AL FORM Phone: (334) or Alabama 242-9500 NO YES NO NO NO NO YES YES MAIL ONLY Harold Brown harold.brown Attn: Office of Child FORM Fax: (334) 242- 334-353-3477 @dhr.alabama. Protective Services INSTRUCTIONS 0939 or harold.brown gov 50 Ripley Street @dhr.alabama.g Montgomery, AL ov 36130 Alabama central registry website Kenneth Should include State of Alaska Saucier agencies cover Office of Children's ocsbackground letter or Photo ID Services AK FORM 06- scanned, Phone: (907) check@alaska. of Applicant. Alaska central Alaska APSIN Unit (Adam 9437 NO YES YES NO NO YES YES faxed, or 30 Days 269-4026 gov Must be signed registry website Walsh checks) mailed and include DOB, 323 East 4th Ave. Fax: (907) 269- SSN, and all Anchorage, AK 99501 4098 known aliases. Their registry is Tufa Avegalio local and not CFSD available online. American Tufanua You must e-mail Samoa Avegalio: the agency to tavegalio@dhs request the s.as form. Jermaine Arizona Department of Additional Moore-Tabron Child Safety For contacts: Jermaine.Moor employment/ Submit to Yvonne Santos eTabron@azds DCSCentralRegi Attn: AWA volunteer DCSCentralRegi Arizona AZ Form 1083a NO NO NO NO NO NO NO Phone: (602) c.gov
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