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CFS 1800BG Rev 1/2018 State of Illinois Department of Children and Family ServicesSUBSIDIZED GUARDIANSHIP APPLICATION(SECTION I TO BE COMPLETED BY THE WORKER)If you do not wish to apply for subsidized

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How to fill out acknowledgement of mandated reporter

01

Step 1: Start by providing your personal information such as your name, address, and contact information.

02

Step 2: Indicate your role or position as a mandated reporter, and provide any relevant identification number or license information.

03

Step 3: Specify the date and location of the incident or observation that you are reporting.

04

Step 4: Describe the details of the incident or observation accurately and thoroughly. Include any relevant information such as names, dates, locations, and specific actions or behaviors witnessed.

05

Step 5: Sign and date the acknowledgement form to certify that the information provided is true and accurate to the best of your knowledge.

06

Step 6: Submit the completed form to the appropriate authority or agency responsible for handling mandated reporter acknowledgements.

Who needs acknowledgement of mandated reporter?

01

Any individual who is legally designated as a mandated reporter is required to fill out an acknowledgement of mandated reporter. This may include professionals such as teachers, healthcare workers, social workers, childcare providers, law enforcement personnel, and others specified by local laws or regulations.

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