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Print SUSPECTED CHILD ABUSE REPORT To Be Completed by Mandated Child Abuse Reporters CASE NAME: Pursuant to Penal Code Section 11166B. REPORT. REPORTING NOTIFICATION PARTYPLEASE PRINT OR TYPE NAME

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What is reporters business/agency name?

The reporters business/agency name is the name of the company or organization that is being reported on.

Who is required to file reporters business/agency name?

The individuals or entities who are required to file reporters business/agency name are typically those who have ownership or significant control over the business/agency.

How to fill out reporters business/agency name?

Reporters can fill out the business/agency name by providing the full legal name of the company or organization.

What is the purpose of reporters business/agency name?

The purpose of reporters business/agency name is to accurately identify the entity being reported on and to provide transparency.

What information must be reported on reporters business/agency name?

The information that must be reported on reporters business/agency name typically includes the full legal name of the company or organization.

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