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Date if applicable. Send to Centralized Intake at the address list on page 2. xx/xx/xxxx 2. List of child ren suspected of being abused or neglected Attach additional sheets if necessary NAME BIRTH DATE SOCIAL SECURITY SEX RACE Melissa James 03/25/xxxx Unknown Female AA/C William James 04/17/xxxx Male 03/11/xxxx Caucasian Steven Miller 05/10/xxxx Afr. Amer 5. A. 238 of 1975. Mandatory. None. XX/XX/XXXX GENERAL INFORMATION This form is to be completed as the written follow-up to the oral...
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Log 1234567 is a record of activities or events.
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The purpose of log 1234567 is to maintain a record of specific activities or events for regulatory compliance or tracking purposes.
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