The An 048 Arizona form is a document used by the Arizona Department of Economic Security to conduct a records clearance for adoptive families. This form is essential for checking the Child Protective Services Central Registry for any history of prior reports involving household members. Completing this form ensures that all necessary information is gathered to maintain the safety and well-being of children in adoptive homes.
When filling out the AN-048 Arizona form, it is essential to follow certain guidelines to ensure accuracy and compliance. Here are five things you should do and five things you should avoid:
When filling out the AN-048 Arizona form for Child Protective Services Central Registry Records Clearance, consider the following key takeaways:
The AN 048 form is used to request a records clearance from the Arizona Child Protective Services (CPS) Central Registry. It is required for all household members of an adoptive family to check for any history of prior reports related to child welfare.
All adult household members must complete the AN 048 form. This includes the adoptive father, adoptive mother, and any other adults living in the household. Additionally, the form must include information about any children in the household, whether they are biological, adopted, or otherwise.
The information provided on the AN 048 form is used to check the CPS Central Registry for any prior reports or substantiated findings related to child abuse or neglect. This process helps ensure the safety and well-being of children in the adoptive home.
Once completed, the AN 048 form should be mailed to the Arizona Department of Economic Security at the following address: P.O. Box 44240, Phoenix, AZ 85064-4240.
After submission, CPS personnel will review the information provided and check the Central Registry. They will then determine if there are any substantiated reports. You will receive a response indicating whether there are any findings.
Yes, the information provided on the AN 048 form is confidential. It can only be released to individuals authorized by state and federal law, ensuring the privacy of all household members.
If you have a disability and require assistance, you should inform the Department of your needs in advance, if possible. They can provide accommodations, such as sign language interpreters or alternative formats of the document.
If you discover any errors after submitting the AN 048 form, contact the Arizona Department of Economic Security as soon as possible. It is important to ensure that all information is accurate to avoid delays in processing your records clearance.
For more information about the AN 048 form or the records clearance process, you can contact the Arizona Department of Economic Security at (602) 542-3598. For TTY/TTD services, dial 7-1-1.
When navigating the adoption process in Arizona, the AN 048 form is a crucial document for obtaining a Child Protective Services (CPS) Central Registry Records Clearance. However, several other forms and documents are often required alongside it to ensure a smooth and compliant adoption process. Below is a list of commonly used documents that may accompany the AN 048 form.
Understanding these documents and their purposes can significantly ease the adoption process. Each plays a vital role in ensuring that the adoption is in the best interest of the child and that all legal requirements are met. Being prepared with these forms can help foster a smoother experience for everyone involved.
Arizona New Hire Forms - This form is available online for ease of access and completion.
Arizona Poa - Appointees must declare their qualification to represent the claimant under Arizona law.
Repo Affidavit - Legal compliance is paramount in completing the Arizona Repossession Affidavit.
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.
Filling out the AN 048 form is an important step in the process of obtaining a records clearance from the Arizona Child Protective Services. Follow these steps carefully to ensure that all necessary information is provided accurately.
Once you have completed the form, make sure to double-check all the information for accuracy. After verifying everything, mail the form to the address provided at the top. This will initiate the process for your records clearance.
Filling out the AN-048 Arizona form can be a straightforward process, but many individuals make common mistakes that can delay their application. One frequent error is failing to include all household members. The form requires information for every adult living in the home, yet some applicants mistakenly only list themselves and their partner. This omission can lead to processing delays or even rejection of the application.
Another common mistake involves inaccuracies in names. It is essential to provide the full legal names of all individuals, including any other names used. Applicants often forget to include maiden names or previous married names for the adoptive mother, which can create confusion during the background check process. Ensuring that all names are accurately recorded is crucial.
People also tend to overlook the importance of providing complete addresses. Each household member’s address must be filled out completely, including the street number, city, state, and ZIP code. Missing or incorrect address information can hinder the ability of Child Protective Services to conduct a thorough background check.
Another mistake is not including Social Security numbers. The form explicitly requests this information for each adult household member. Some applicants might skip this section due to privacy concerns, but omitting the Social Security number can significantly delay the clearance process.
Additionally, applicants sometimes fail to sign the form. The certification statement at the bottom requires signatures from the adopting father, mother, and any other adult household members. Without these signatures, the form is incomplete and cannot be processed.
People may also neglect to double-check the birthdates provided. Incorrect birthdates can lead to mismatches during the verification process. It is advisable to verify this information against official documents to ensure accuracy.
Another frequent oversight is not providing a contact phone number. The agency may need to reach out for clarification or additional information. Without a valid phone number, communication can become challenging, resulting in unnecessary delays.
Lastly, many individuals fail to read the instructions carefully. The form contains important details regarding how to complete it properly. Taking the time to review the instructions can help prevent many of the aforementioned mistakes, ensuring a smoother application process.