The Central Registry Release Information form is a critical document used by the Virginia Department of Social Services. It facilitates the search for individuals identified as abusers or neglectors in child abuse or neglect investigations within the state. By completing this form accurately and paying the search fee, individuals and agencies can request information from the Virginia Child Abuse and Neglect Central Registry, which is essential for various purposes, including employment in sensitive sectors.
To ensure a smooth and expedient process, it is recommended to read all instructions thoroughly, answer all questions in detail, and submit the form along with the required fee. If you need to fill out the form, click the button below.
The Virginia Department of Social Services plays a pivotal role in safeguarding children against abuse and neglect through its Central Registry Release of Information Form. This essential document, intertwined with the state's child protective laws, is designed to meticulously document individuals found culpable in child abuse or neglect investigations. Ensuring accuracy and completeness is paramount, as the information serves a critical function in various professional and legal contexts, including adoption, child care, schooling, and numerous other scenarios where child safety is paramount. With a meticulous process that includes notarization and a modest fee, the form represents a gateway to important background checks conducted by the Office of Background Investigations - Search Unit located in Richmond, VA. Beyond its immediate function, the form embodies Virginia's commitment to child welfare, operating under stringent legal mandates to provide and maintain a central registry, thereby offering a crucial mechanism for organizations and individuals to verify the background of potential caregivers or employees involved with children. As such, the Central Registry Release of Information Form is more than a document; it is a testament to a societal pledge to protect its most vulnerable members.
VA Department of Social Services
Central Registry Release of Information Form
Office of Background Investigations – Search Unit
801 East Main Street, 6th Floor, Richmond, VA 23219-2901
Search Fee $10.00
INSTRUCTIONS
Purpose
The Virginia Child Abuse and Neglect Central Registry is mandated by the Virginia Child Protective Law and contains the names of individuals identified as an abuser or neglector in founded child abuse and/or neglect investigations conducted in the state of Virginia. The findings are made by Child Protective Services staff in local departments of social services and are maintained by the Virginia Department of Social Services. Legal mandates for the Virginia Department of Social Services to provide a Central Registry and a mechanism for conducting searches of the registry are found in § 63.2-1515 of the Code Virginia.
Read all instructions before completing the form: (Incomplete forms will be returned)
1.Answer all questions completely and accurately by printing clearly in black ink or typing your answers. Failure to complete or print clearly may delay or deny your request. Given the nature of the form and the actions to be taken when received, the Office of Background Investigations shall not accept forms that have been altered in any fashion. Forms that contain strike outs, correction tape or white-out will be returned.
2.If a middle name is an initial, indicate “initial only” otherwise, enter a full middle name given at birth.
3.For “other names used” list all previous names; nick names, all previous married names, legal name changes, changes due to adoption, etc. Circle appropriate title description on the form.
4.If the answer to any question is none, write “N/A“.
5.Sign the Central Registry Release of Information Form in the presence of an official Notary Public. Each
request form must be notarized. Only original signatures will be accepted. No copies of the form will be accepted.
6.A $10.00 fee is charged for each search. Payment must accompany search forms. Only money orders, company/business checks, or cashier checks will be accepted. (If multiple requests are mailed together, payment may be combined on in one money order, company/business check, or cashier’s check.
(ex. 4 requests at $10.00 each will total $40.00). A $50 fee will be charged for all returned checks.)
All money orders, company/business checks, or cashier checks should be made payable to: Virginia Department of Social Services.
Personal checks and cash will not be accepted.
7.For agencies and facilities that require several searches per year, an agency code will be assigned to expedite processing of the search requests.
8.If additional space is needed to complete the form (ie. providing information on addresses, spouses, and children) attach an 8x11 sheet sheet of paper along with your form to be mailed.
9.Search results are not transferable and are not considered official beyond the requesting agency or individual.
10.Mail your completed form and additional sheets (if used) to:
Virginia Department of Social Services
Office of Background Investigations - Search Unit 801 East Main Street, 6th Floor
Richmond, VA 23219-2901
032-02-0151-12-eng (08/15)
Purpose of Search, Check one:
Adam Walsh Law
Adoptive Parent
Babysitter/Family Day Care
CASA
Children’s Residential Facility
Custody Evaluation
Day Care Center
Foster Parent
Institutional Employee
Other Employment
School Personnel
Volunteer
Other
MAIL SEARCH RESULTS TO: Agency, Individual or Authorized Agent Requesting Search
Name
Payment/FIPS Code
(Use only if assigned by OBI-CRU)
Address
City
State
Zip
Contact Name
Tel.#
Ext
Mandatory if agency code
Contact E-Mail
has been assigned
PART I: DETAILS OF INDIVIDUAL WHOSE NAME MUST
BE SEARCHED
Last Name
First Name
Full Middle Name – (given at birth) - No initials
(if middle name is an initial, indicate "Initial Only")
Maiden Name (last name before marriage)
Sex
Date of Birth (MM/DD/YYYY)
Race
Male
Female
Driver's License Number or ID #
Social Security Number
Other names used; nicknames, legal names (refer to instruction page)
Current Address (Include Street # and Apt #)
Applicant’s Prior Addresses
Include Street # and Apt #
Start Date (MM/YY)
End Date (MM/YY)
Marital Status
Single
Married
Divorced
Widowed
Partner
If married, list current spouse. If previously married, list all previous spouses. If you have never been married, write ‘N/A’.
Full Middle Name
Maiden Name
Date of Birth
(given at birth)
(MM/DD/YYYY)
List all of your children. If you have none, write ‘N/A’. Include all adult children, step and foster children not living with you.
Relationship
VA Department of Social ServicesCentral Registry Release of Information Form
PART II: CERTIFICATION AND CONSENT FOR RELEASE OF INFORMATION
I hereby certify that the information contained on this form is true, correct and complete to the best of my knowledge. Pursuant to Section 2.2-3806 of the Code of Virginia, I authorize the release of personal information regarding me which has been maintained by either the Virginia Department of Social Services or any local department of social services which is related to any disposition of founded child abuse/neglect in which I am identified as responsible for such abuse/neglect. I have provided proof of my identity to the Notary Public prior to signing this in his/her presence.
Signature of person whose name is being searched (Sign in presence of Notary)
Parent or Guardian signature required for minor children under the age of 18
PART III: CERTIFICATE OF ACKNOWLEDGEMENT OF INDIVIDUAL
City/County of
Commonwealth/State of
Acknowledged before me this
day of
, year
Notary Public Signature1otary Number
My Commission Expires:
Notary Seal
PART IV: CENTRAL REGISTRY FINDINGS – COMPLETED BY CENTRAL REGISTRY STAFF ONLY
1.We are unable to determine at this time if the individual for whom a search has been requested is listed in the Central Registry. Please answer the following questions and return to the Central Registry Unit in order for us to make a determination:
Worker:Date:
2.Based on information provided by the Local Department of Social Services, we have determined that
is listed in the Child Abuse/Neglect Central Registry with a
founded disposition of child abuse/neglect. For more detailed information, contact the
Dept. of Social Services in reference to referral
phone#
3.As of this date, based on the information provided, the individual whose name was being searched is NOT identified in the Central Registry of Child Abuse/Neglect.
Signature of worker completing search:
Date:
OBI Staff Only
Once you've received the Central Registry Release Information form, it's important to fill it out correctly to avoid any delays in processing. This form is a crucial step for individuals seeking to confirm their status relating to child abuse and neglect investigations in Virginia. By completing this form, you're requesting a search of the Virginia Child Abuse and Neglect Central Registry. Here are the steps to do so accurately and efficiently.
After your form has been submitted, it will be reviewed by the Office of Background Investigations – Search Unit. The search outcomes will directly follow from the information you've provided and will be communicated to the requesting agency or individual. It's important to remember that search results are specific to the individual request and are not transferable or considered official beyond the initial inquiry.
What is the purpose of the Virginia Child Abuse and Neglect Central Registry Release of Information Form?
The Central Registry Release of Information Form is designed to facilitate background checks by providing access to information regarding individuals identified as abusers or neglectors in child abuse and/or neglect investigations found within the state of Virginia. These investigations are conducted by Child Protective Services staff across various local departments of social services and the findings are maintained by the Virginia Department of Social Services. The registry aims to ensure the safety and well-being of children by allowing certain entities to verify if an individual has a history of founded child abuse or neglect.
How should the form be filled out and what are the implications of incomplete submissions?
It's important to complete the form accurately and legibly, using black ink for printing or typing the answers. Every question should be answered fully as incomplete forms will be returned, potentially delaying or denying the request. Alterations, including strike outs or the use of correction tape, are not permitted, and such forms will also be returned. The thorough and precise completion of the form is crucial as it ensures the accuracy and efficiency of the background check process.
What is the fee for conducting a search using the Central Registry Release of Information Form and what forms of payment are accepted?
Each search request submitted through the Central Registry Release of Information Form incurs a fee of $10.00. Payments must accompany the search form and can be made via money orders, company/business checks, or cashier's checks. A sum of $50 will be charged for all returned checks. It is noteworthy that personal checks and cash are not accepted. For convenience, when mailing multiple requests together, payment can be combined into one instrument reflecting the total fee amount due.
Who needs to notarize the Central Registry Release of Information Form and why is it necessary?
The form must be signed in the presence of an official Notary Public, a requirement that ensures the authenticity of the signature and protects against identity theft and fraud. Only original signatures will be accepted for this purpose. Notarization serves as a protective legal formalization that verifies the identity of the individual signing the form, thereby reinforcing the reliability and accuracy of the submitted information.
Can the results of the search be used by or transferred to other agencies or individuals?
Search results obtained through the Central Registry Release of Information Form are specifically intended for the agency or individual that requested them and are not transferable. Furthermore, these results are not considered official beyond the initial requestor. This measure ensures the privacy and security of the detailed information, limiting its use to the intended context of protecting the welfare of children within a specific scope of enquiry.
Filling out the Central Registry Release Information form requires attention to detail and careful adherence to instructions. However, many individuals make common mistakes that could delay or jeopardize the processing of their requests. Understanding these pitfalls can ensure a smoother experience.
The first common error occurs when individuals do not answer all the questions fully or accurately. It’s crucial to print answers clearly in black ink or type them. Any unclear or incomplete responses can lead to delays or outright denial of the request. Always review your answers for completeness and legibility before submitting the form.
Another mistake involves how middle names are recorded on the form. If a person’s middle name is just an initial, it's essential to write “initial only”. Otherwise, the full middle name given at birth should be provided. Ignoring this instruction can result in unnecessary confusion or the need to resubmit the form.
People also falter when listing “other names used”. Including all previous names—such as nicknames, previous married names, and names changed legally or through adoption—is critical. Failure to provide this comprehensive history can hinder the accuracy of the search results.
Another common oversight is not correctly indicating the answer ‘none’ for applicable questions. Writing “N/A” where appropriate is a simple but necessary step to ensure that every question is addressed, making it clear to the reviewers that no information was overlooked or omitted deliberately.
Signatures present another critical step where errors occur. The form must be signed in the presence of an official Notary Public, and only original signatures are accepted. Failing to have the form notarized or submitting a photocopy of the signed form can lead to its rejection.
Proper payment is essential, yet often mishandled. The form clearly states that a $10.00 fee must accompany each search request and specifies acceptable forms of payment. Personal checks and cash are not accepted, and overlooking this detail can stall the process.
For those requiring additional space to provide comprehensive information, attaching an 8x11 sheet of paper is allowed. However, some fail to take advantage of this option, leading to incomplete details that could be crucial for the search.
Lastly, a significant error made by applicants is mailing incomplete forms and attachments. Every piece of required information and any additional sheets used must be mailed to the provided address. Omitting any part of the application package could lead to delays or the inability to carry out the search effectively.
Avoiding these common mistakes requires careful reading of the instructions and double-checking all answers and attachments before mailing. Doing so increases the likelihood of a timely and accurate search result from the Central Registry.
When individuals or entities need to request information from the Virginia Child Abuse and Neglect Central Registry, often it is part of a broader background check or information gathering effort. Alongside the Central Registry Release Information form, several other forms and documents are commonly used to ensure a comprehensive understanding of an individual's background, especially in situations where ensuring the safety and welfare of children is paramount. Here's a look at some of these key documents.
Each of these forms plays a vital role in assembling a detailed profile of an individual, aiding in making informed decisions regarding employment, volunteer opportunities, foster care, adoption, and other scenarios where trust and safety are critical. Together, they provide a comprehensive toolkit for conducting thorough background checks and evaluations.
Employment Background Check Authorization forms are quite similar to the Central Registry Release of Information form. Both types of documents are designed to authorize the release of personal information for the purpose of verifying an individual's background. This similarity extends to requiring explicit consent from the individual whose information is being checked, to perform checks that might include criminal records, past employment verification, or checks against specific registries, and to ensure compliance with privacy and data protection laws.
Volunteer Screening forms share a common purpose with the Central Registry Release form, particularly in contexts where volunteers might work with vulnerable populations. Like the Central Registry Release, these forms typically require personal information, past addresses, and consent to conduct a background check, ensuring that volunteers are suitable for roles involving children, the elderly, or other protected groups. This includes checks against abuse or neglect registries, criminal records, and sometimes reference checks to safeguard those under the care of non-profit organizations.
Child Care Licensing Application forms closely resemble the Central Registry Release of Information form's intent and content. Those applying for licensure to operate child care facilities must often consent to checks against abuse and neglect registries, similar to the checks conducted through the Central Registry form. Both forms serve to protect children's welfare by ensuring those in charge have no history of abuse or neglect.
Adoption Application forms share similarities with the Central Registry Release of Information form, especially in requiring comprehensive personal information and consent for background checks. These checks, crucial in adoption processes, may include searches in child abuse and neglect registries to ensure the safety and well-being of children to be adopted. The goal is to verify the suitability of prospective adoptive parents.
Foster Care Licensing forms, similar to the Central Registry Release of Information form, are designed to protect children’s welfare. Applicants must provide detailed personal information and agree to background checks, including searches in child abuse and neglect registries. This process ensures that individuals seeking to become foster parents have no history of harming children.
Professional Licensing Application forms, for professions such as teaching, nursing, or counseling, resemble the Central Registry Release of Information form in demanding background checks against abuse and neglect registries. This ensures that professionals who will work with vulnerable populations do not have a history of misconduct related to their profession or towards children and other vulnerable groups.
Gun Purchase Background Check forms, though serving a different primary purpose, share the prerequisite of consenting to a background investigation similar to the Central Registry check. Applicants consent to have their personal history reviewed to ensure they meet legal requirements for ownership, reflecting the broader theme of preventing harm by verifying personal backgrounds.
Notary Public Application forms often require a background check similar in nature to what is described in the Central Registry Release of Information form. Applicants must consent to have their information verified to ensure they are fit to perform the duties of a notary, which demands a high level of trust and integrity.
Tenant Screening forms share a foundational similarity with the Central Registry Release form in that both require the subject's consent for a background check. While tenant screening primarily focuses on financial and rental history, the emphasis on consent and the purpose of protecting property owners’ interests align with the intentions behind child abuse and neglect registry checks.
Security Clearance forms for government employment or private sector roles requiring access to sensitive information often necessitate a thorough background check, analogous to the Central Registry Release of Information process. Applicants must provide detailed personal information and consent to extensive background investigations, including checks against any pertinent registries to ensure national security and protect sensitive information.
When filling out the Central Registry Release Information form, it's important to follow specific guidelines to ensure the processing of your request is smooth and without delay. Here are some key do's and don'ts to consider:
By following these guidelines, you help ensure that your request for a search in the Virginia Child Abuse and Neglect Central Registry is processed efficiently and without unnecessary delays.
There are several common misconceptions about the Central Registry Release of Information form used by the Virginia Department of Social Services. Understanding these misconceptions can help individuals and agencies navigate the process more effectively.
In reality, the form explicitly requires that all answers are completed accurately by printing clearly in black ink or by typing the answers. This ensures clear readability and prevents processing delays.
However, the form specifically states that it will not be accepted if altered with strike outs, correction tape, or white-out. Such forms will be returned to the sender.
The instructions demand that a full middle name given at birth is provided unless the middle name is genuinely just an initial. This requirement helps in accurately identifying the individual in question.
Contrary to this belief, only original signatures will be accepted and each form must be notarized to ensure the authenticity of the document.
The form clearly states that only money orders, company/business checks, or cashier's checks are accepted, with personal checks and cash explicitly not accepted, to avoid issues with payment processing.
It is clarified that search results are not transferable and are considered official only for the requesting agency or individual. This limits the scope of where and how the information can be used legally.
The correct procedure for including more information than the form allows is to attach an 8x11 sheet of paper. This ensures that all relevant details are properly documented and presented in an organized manner.
Understanding these key points about the Central Registry Release of Information form can help ensure that the process of submitting a request is done correctly and efficiently.
Filling out the Central Registry Release of Information Form is crucial for anyone required to undergo a background investigation for roles that involve interacting with children in Virginia. Here are key takeaways to ensure the process is completed accurately and efficiently:
By paying close attention to these key points, individuals and organizations can navigate the form submission process more smoothly, ensuring that necessary background checks are carried out efficiently.
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