INSTRUCTIONS: ARIZONA REQUEST FOR CHILD PROTECTIVE SERVICES REPORT (Form PS-042)

Any person who believes an Arizona child protective services report has been filed about them may request a copy by filing a form PS-042, such as parents or legal guardians making a request on behalf of their children. This document can be obtained from the website maintained by the Arizona Department of Economic Security.

Arizona Request For Child Protective Services Report PS-042 Step 1: In the first blank box, enter the last name, first name and middle initial of the requester.

Arizona Request For Child Protective Services Report PS-042 Step 2: In the second blank box, enter the birth date of the requester.

Arizona Request For Child Protective Services Report PS-042 Step 3: In the third blank box, enter the Social Security number of the requester. Failure to do so may result in an inability to locate the documents requested.

Arizona Request For Child Protective Services Report PS-042 Step 4: In the fourth blank box, enter the street address, city, state and zip code of the requester.

Arizona Request For Child Protective Services Report PS-042 Step 5: In the fifth blank box, enter the work and home phone numbers of the requester, including their respective area codes.

Arizona Request For Child Protective Services Report PS-042 Step 6: The table provided below requires documentation of all child victims concerned in these reports. In the first column, enter the name of the child.

Arizona Request For Child Protective Services Report PS-042 Step 7: In the second column, enter any other spellings of the childrens' names.

Arizona Request For Child Protective Services Report PS-042 Step 8: In the third column, enter the birthdates of the children.

Arizona Request For Child Protective Services Report PS-042 Step 9: In the fourth column, enter the Social Security numbers of the children.

Arizona Request For Child Protective Services Report PS-042 Step 10: In the blank section below, enter any other information which can help identify the requested report.

Arizona Request For Child Protective Services Report PS-042 Step 11: Indicate with a check mark which of the four listed statuses describes you as the requester.

Arizona Request For Child Protective Services Report PS-042 Step 12: Sign and date the bottom of the form. This form should be witnessed by a notary public or, if one is unavailable, a Child Protective Services staff member.