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CHILDLIKE AND ABUSE REGISTRY. O. BOX 8170HARRISBURG, PENNSYLVANIA 171058170CONSENT/RELEASE OF INFORMATION AUTHORIZATION FORMER THE PENNSYLVANIA CHILD ABUSE HISTORY CERTIFICATION, (), hereby authorize
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The name of the requesting agency is the agency or organization that is requesting a specific action or service.
The person or entity requesting the action or service is required to file the name of the requesting agency.
The name of the requesting agency should be clearly written or typed on the appropriate form or document.
The purpose of providing the name of the requesting agency is to ensure proper identification and communication between the parties involved.
The name of the requesting agency must include the full legal name or official title of the agency or organization.
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