The AN 048 Arizona form is a document used to request a records clearance from the Child Protective Services Central Registry. This form is essential for adoptive families, as it helps ensure the safety and well-being of children by checking for any prior reports. To get started, fill out the form by clicking the button below.
The AN 048 form is an essential document for families pursuing adoption in Arizona. This form is specifically designed for the Child Protective Services (CPS) Central Registry records clearance process. It ensures that all household members, including adoptive parents and other adults living in the home, are thoroughly vetted for any prior reports related to child welfare. The information collected includes names, birthdates, Social Security numbers, and addresses of all household members, as well as details about any children currently living in the home. Completing this form accurately is crucial, as it plays a significant role in safeguarding the well-being of children placed for adoption. The confidentiality of CPS records is strictly maintained, and the form must be mailed to the designated address for processing. By following the necessary steps and providing truthful information, families can help facilitate a smoother adoption process while complying with state and federal regulations.
AN-048 (6-06)
ARIZONA DEPARTMENT OF ECONOMIC SECURITY
Child Protective Services Central Registry, 050C-3
P.O. Box 44240 • Phoenix, AZ 85064-4240
ADOPTIVE FAMILIES CENTRAL REGISTRY RECORDS CLEARANCE
Child Protective Services (CPS) records are confidential and can be released only to those individuals permitted by state (A.R.S. § 8-807) and federal law. This form is to be completed for all household members. The requested information will be used to check the Child Protective Services Central Registry for any history of prior reports. Mail to address above.
ADOPTIVE FATHER’S NAME (Last, First, Middle)
BIRTHDATE
SOC. SEC. NO.
OTHER NAMES USED
ADOPTIVE FATHER’S ADDRESS (No., Street, City, State, ZIP)
ADOPTIVE MOTHER’S NAME (Last, First, Middle)
OTHER NAMES USED (Include maiden name and prior married names)
ADOPTIVE MOTHER’S ADDRESS (No., Street, City, State, ZIP)
OTHER ADULT HOUSEHOLD MEMBER’S NAME (Last, First, Middle.)
OTHER ADULT HOUSEHOLD MEMBER’S ADDITIONAL ADDRESS (No., Street, City, State, ZIP)
OTHER ADULT HOUSEHOLD MEMBER’S NAME (Last, First, Middle)
Children’s Names (Include birth, adopted and any other children living in household)
CHILD’S NAME (Last, First, Middle)
I certify that all information provided is true and accurate to the best of my knowledge.
ADOPTING FATHER’S SIGNATURE
DATE
ADOPTING MOTHER’S SIGNATURE
OTHER ADULT HOUSEHOLD MEMBERS’ SIGNATURE
NAME OF AGENCY REQUESTING CENTRAL REGISTRY RECORDS CLEARANCE
AREA CODE AND PHONE NO.
CASE MANAGER’S SIGNATURE
NAME AND ADDRESS OF AGENCY TO RECEIVE INFORMATION FROM
TO BE COMPLETED BY CPS PERSONNEL
CENTRAL REGISTRY (THIS BLOCK MUST BE COMPLETED)
Central Registry information checked
There were no substantiated reports.
report(s) attached
SIGNATURE OF PERSON CHECKING CENTRAL REGISTRY
See reverse for Americans with Disabilities Act (ADA) disclosure.
Equal Opportunity Employer/Program ̶ Under Titles VI and VII of the Civil Rights Act of 1964 (Title VI & VII), and the Americans with Disabilities Act of 1990 (ADA), Section 504 of the Rehabilitation Act of 1973, and the Age Discrimination Act of 1975, the Department prohibits discrimination in admissions, programs, services, activities, or employment based on race, color, religion, sex, national origin, age, and disability. The Department must make a reasonable accommodation to allow a person with a disability to take part in a program, service or activity. For example, this means if necessary, the Department must provide sign language interpreters for people who are deaf, a wheelchair accessible location, or enlarged print materials. It also means that the Department will take any other reasonable action that allows you to take part in and understand a program or activity, including making reasonable changes to an activity. If you believe that you will not be able to understand or take part in a program or activity because of your disability, please let us know of your disability needs in advance if at all possible. To request this document in alternative format or for further information about this policy, contact (602) 542-3598; TTY/TTD Services: 7-1-1.
Completing the AN 048 Arizona form is an important step in the process of obtaining a Central Registry records clearance. This form collects essential information about all household members, which will be used to check for any history of prior reports with Child Protective Services.
What is the purpose of the AN 048 Arizona form?
The AN 048 Arizona form is used to request a records clearance from the Child Protective Services (CPS) Central Registry. This process is essential for individuals looking to adopt, as it helps ensure the safety and well-being of children by checking for any prior reports or allegations related to child abuse or neglect. All household members must be listed on the form, as their backgrounds will also be reviewed as part of the clearance process.
Who needs to complete the AN 048 form?
Every adult member of the household, including adoptive parents and any other adults living in the home, must complete the AN 048 form. Additionally, information about all children residing in the household, whether biological or adopted, should be included. This comprehensive approach helps CPS assess the entire environment in which the child will be placed.
How do I submit the AN 048 form?
Once you have filled out the AN 048 form, it should be mailed to the address provided on the form: Arizona Department of Economic Security, Child Protective Services Central Registry, P.O. Box 44240, Phoenix, AZ 85064-4240. Ensure that all required information is accurate and complete to avoid delays in processing your request.
What happens after I submit the AN 048 form?
After submission, the CPS will review the information provided and check the Central Registry for any substantiated reports. You will receive a response indicating whether there were any findings or if there are no substantiated reports against the individuals listed. This process is crucial in determining the suitability of the household for adoption.
Is the information provided on the AN 048 form confidential?
Yes, the information submitted on the AN 048 form is confidential and is protected under both state and federal laws. It can only be released to individuals who are authorized to receive it. This confidentiality is vital to protect the privacy of all individuals involved, especially children, during the adoption process.
When filling out the AN-048 form for the Arizona Child Protective Services Central Registry, many individuals make common mistakes that can lead to delays or complications in the adoption process. Understanding these pitfalls can help ensure that your application is processed smoothly.
One frequent error is failing to include all household members. The form requires information for every adult living in the home, including their names, birthdates, and social security numbers. Omitting anyone can result in an incomplete application, which may cause delays in processing.
Another mistake is not providing accurate names. When listing names, it's crucial to include all variations, such as maiden names or prior married names. If these names are not included, it can complicate background checks and may lead to unnecessary inquiries.
Many people also overlook the importance of double-checking personal information. Typos in names, birthdates, or social security numbers can create significant issues. A simple misspelling can lead to mismatches in records, causing further delays in the approval process.
In addition, some applicants forget to sign the form. The signatures of both adoptive parents and any other adult household members are required. Without these signatures, the form is considered incomplete and cannot be processed.
Another common oversight is neglecting to provide a current address. The form asks for the addresses of the adoptive parents and any other adult household members. If these addresses are outdated or incorrect, it can lead to communication issues with the agency.
People sometimes fail to include all children in the household. The form requests names and birthdates for all children, whether biological, adopted, or otherwise. Missing this information can raise questions and potentially delay the process.
Some applicants misunderstand the certification statement at the end of the form. It is essential to certify that all information provided is true and accurate. Failing to do so may lead to legal repercussions or a denial of the application.
Finally, many individuals do not pay attention to the mailing instructions. It is vital to send the completed form to the correct address provided at the top of the document. Sending it to the wrong location can result in significant delays.
By being aware of these common mistakes, applicants can take steps to ensure their AN-048 form is completed accurately and efficiently. This proactive approach can help facilitate a smoother adoption process.
When completing the AN-048 form for Arizona's Child Protective Services Central Registry, you may also need several other documents. Each of these forms plays a critical role in the adoption process and helps ensure that all necessary information is gathered and verified.
Gathering these documents is essential to ensure a smooth adoption process. Each one plays a vital role in verifying the suitability of the adoptive family and protecting the interests of the child. Being prepared with these forms will help streamline the journey toward adoption.
The AN 048 Arizona form is essential for adoptive families seeking a records clearance from the Child Protective Services Central Registry. Several other documents share similarities with this form, primarily in their purpose of ensuring safety and compliance in family-related matters. Here are four documents that resemble the AN 048 Arizona form:
When filling out the AN 048 Arizona form, there are several important guidelines to keep in mind. Here is a list of things you should and shouldn't do:
Understanding the AN 048 Arizona form can be challenging, and several misconceptions often arise. Here are eight common misunderstandings about this important document:
By clarifying these misconceptions, individuals can better navigate the adoption process in Arizona and ensure they complete the AN 048 form accurately and effectively.
When filling out the AN 048 Arizona form, it's important to keep several key points in mind:
By following these guidelines, you can ensure that your form is filled out correctly and processed without unnecessary delays.