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Liberty Union High School District 20 Oak Street Brentwood, CA 94513 Phone: (925) 6342166 Fax (925) 6341687 Eric L. Volta, SuperintendentAdministrative Regulation (AR) 4112.9 Exhibit B As an employee
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01
Obtain a copy of the 51414e form that needs to be filled out.
02
Provide your contact information at the top of the form.
03
List the names of the child(ren) who may have been abused or neglected.
04
Sign and date the statement at the bottom of the form.
05
Submit the completed form to the appropriate agency or organization.

Who needs 51414e bsigned statement-child abuse?

01
Any individual who suspects or has knowledge of child abuse or neglect may need to fill out a 51414e signed statement-child abuse.
02
This form may be required by law enforcement, social services, or other agencies involved in investigating allegations of child abuse.
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51414e bsigned statement-child abuse is a legal document that is used to report suspected child abuse or neglect.
Certain professionals, such as teachers, doctors, and social workers, are required by law to file a 51414e bsigned statement if they suspect child abuse or neglect.
To fill out a 51414e bsigned statement, the person making the report must provide detailed information about the suspected abuse or neglect, including the names of the child and the alleged abuser, as well as any relevant details or evidence.
The purpose of a 51414e bsigned statement is to ensure that suspected cases of child abuse or neglect are reported promptly and accurately, so that appropriate action can be taken to protect the child.
The 51414e bsigned statement must include information about the child, the alleged abuser, the nature of the suspected abuse or neglect, and any evidence or details that support the report.
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