Circuit 10 - Florida's Center for Child Welfare | Home



DILIGENT SEARCH REQUEST FOR (THE PARENT)

Requested by __________________________________________ Date _____________________

Telephone #:_______________________ ( ) DCF ( ) CHS ( ) Dev ( ) Gulf Coast ( ) OHU

Assigned Attorney: ___________________________________

Caseworker: ___________________________________

Dependency [ ] TPR [ ] Arrg/PCAR Date: __________________

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Case Name (list oldest child first) Case No: _________________________________

____________________________________ DOB ____________________

____________________________________ DOB ____________________

____________________________________ DOB ____________________

____________________________________ DOB ____________________

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INFORMATION of the PARENT in question:

Name _____________________ _____________________ ___________________

First Middle Maiden Last

A/k/a _____________________________________________________________________________

Race: __________________ DOB:____________________ SS#:__________________________

Last known addresses/locations (include city and/or state even if full address unknown)

________________________________________________________________________________

________________________________________________________________________________

Has parent ever been in jail? Yes [__] No [__] Unknown [__]

If yes, where? ______________________________________________________________________________

______________________________________________________________________________

PLEASE DO NOT SUBMIT A DILIGENT SEARCH REQUEST UNTIL YOU HAVE INQUIRED FROM THE FOLLOWING SOURCES FOR INFORMATION ON THE LOCATION OF THE PARENT IN QUESTION:

Did you contact the child(ren)'s other mother? Yes [__] No [__]

Name: _______________________________

Results: ________________________________________________________________________________

Did you contact the child(ren)'s father? Yes [__] No [__]

Name: ________________________________________________

Results: ________________________________________________________________________________

Did you contact the maternal grandparent(s)? Yes [__] No [__]

Name(s):___________________________

Results: ________________________________________________________________________________

Did you contact the paternal grandparent(s)? Yes [__] No [__]

Name(s):____________________________

Results: ________________________________________________________________________________

Did you contact other relatives? Yes [__] No [__] No relatives/other relatives found [__]

Name(s) & Relation(s):_______________________________________________________________________

Results: ________________________________________________________________________________

Did you contact friends/others? Yes [__] No [__]

Name(s):________________________________________

Results: ________________________________________________________________________________

Child(ren)’s birth certificate(s): Yes [__] No [__]

Results: ______________________________________

Child(ren)’s school records: Yes [__] No [__]

Results: __________________________________________

Military Service (Ask relatives): Yes [__] No [__]

If yes in what branch? _______________________

Polk County Sheriff's Department: Yes [__] No [__]

Results: _________________________________________________________________________

________________________________________________________________________________

Polk County Jail: inquiry.html Yes [__] No [__]

Results: _________________________________________________________________________

________________________________________________________________________________

Hardee County Sheriff's Dept.: Yes [__] No [__]

Results: _________________________________________________________________________

________________________________________________________________________________

Highlands County Sheriff's Dept.: Yes [__] No [__]

Results: _________________________________________________________________________

________________________________________________________________________________

Florida Department of Corrections: dc.state.fl.us/ActiveInmates/search.asp

Yes [__] No [__]

Results: ________________________________________________________________________________

Federal Bureau of Prisons at Yes [__] No [__]

Results: ______________________________________________________________

Telephone book: Yes [__] No [__]

Results: ____________________________________________________

Contact attempted at last known address: Yes [__] No [__]

Results: _________________________________________________________________________

________________________________________________________________________________

Other sources: ____________________________________________________________________________

________________________________________________________________________________

I have searched the above sources for information, but have not been able to contact the parent in question.

____________________________________________ _________________________

Signature of Caseworker Date

PLEASE IMMEDIATELY CONTACT Linda Eldredge if parent is located or you have new information. Phone Number: (863) 519-8900 ext. 210

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