Department of Family and Children S Services s1

Department of Family and Children S Services s1

<p> Santa Clara County Social Services Agency Department of Family and Children’s Services REQUEST FOR LOCATION SERVICES</p><p>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</p><p>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</p><p>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:</p><p>Child(ren)’s Name DOB Petition # Place of Birth</p><p>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): </p><p>SCZ659 Filing: 3rd Fastener, 3rd Divider, Under Request for Location Services – 3/10/15</p><p>Page 1 of 2 Relatives of Subject:</p><p>Name: Relationship: Address: Telephone: </p><p>Name: Relationship: Address: Telephone: </p><p>Name: Relationship: Address: Telephone: </p><p>Social Worker’s Preliminary Search Activities These are minimal search activities prerequisite to requesting location services.</p><p>Activities Date Results</p><p>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: </p><p>Submitted by:</p><p>Social Worker’s Name (Please Print) S.W. # Telephone # Email</p><p>SCZ659 Filing: 3rd Fastener, 3rd Divider, Under Request for Location Services – 3/10/15</p><p>Page 2 of 2</p>

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