_____ of criminal and civil Background Checks and taken appropriate Reviewed the results action per DCS child welfare policy13.4 (previously 2.11). _______________________________________ ______________________ Signature of Provider Date _______________________________________ ___ _______________________ Typed or Printed Name Signed Above Title of Signer __________________________________________ _________________________ E-mail Address of Signer Phone Number Send by U.S Postal Service to: DCS, Central Office Background Check Unit Rm. E 306, MS 08 302 W. Washington St. Indianapolis, IN 46204--2739
_____ Reviewed the results of criminal and civil Background Checks and taken appropriate action per DCS child welfare policy13.4 (previously 2.11). _______________________________________ ______________________ Signature of Provider Date _______________________________________ ___ _______________________ Typed or Printed Name Signed Above Title of Signer __________________________________________ _________________________ E-mail Address of Signer Phone Number Send by U.S Postal Service to: DCS, Central Office Background Check Unit Rm. E 306, MS 08 302 W. Washington St. Indianapolis, IN 46204--2739
Post_Adoption_Sample_Contract_2015_RFP(1).docx