VA Department of Social Services Central Regis
try Release of Information Form
Office of Background Investigations – Search Unit
801 East Main Street, 6
Floor, Richmond, VA 23219-2901
Search Fee $10.00
The Virginia Child Abuse and Neglect Central Registry is mandated by the Virginia Child Protective Law and contains
the names o
f individuals identified as an abuser or neglector in founded child abuse and/or neglect investigations
conducted in the state of Virginia. The findings are made by Child Protective Services staff in local departments of
social services and are maintained by the Virginia Department of Social Services. Legal mandates for the Virginia
Department of So
cial Services to provide
a Central Registry and a mechanism for conducting searches of the registry
are found in § 63.2-1515 of the Code Virginia.
Read all instructions before completing the form:
(Incomplete forms will be returned)
1. Answer all questions completely and accurately by printing clearly in black ink or typing your answers. Failure
to complete or print clearly may delay or deny your request. Given the nature of the form and the actions to
be taken when received, the Office of Background Investigations shall not accept forms that have been
altered in any fashion. Forms that contain strike outs, correction tape or white-out will be returned.
4. If the answer to any question is none, write “N/A“.
5. Sign the Central Registry Release of Information Form in the presence of an official Notary Public. Each
request form must be notarized. Only original signatures will be accepted. No copies of the form will be accepted.
6. A $10.00 fee is charged for each search. Payment must accompany search forms. Only money orders,
company/business checks, or cashier checks will be accepted. (If multiple requests are mailed together, payment
may be combined on in one money order, company/business check, or cashier’s check.
(ex. 4 requests at $10.00 each will total $40.00). A $50 fee will be charged for all returned checks.)
All money orders, company/business checks, or cashier checks should be made payable to:
Virginia Department of Social Services.
Personal checks and cash will not be accepted.
7. For agencies and facilities that require several searches per year, an agency code will be assigned to expedite
processing of the search requests.
8. If additional space is needed to complete the form (ie. providing information on addresses, spouses, and children)
attach an 8x11 sheet sheet of paper along with your form to be mailed.
9. Search results are not transferable and are not considered official beyond the requesting agency or individual.
10. Mail your completed form and additional sheets (if used) to:
Virginia Department of Social Services
Office of Background Investigations - Search Unit
801 East Main Street, 6th Floor
Richmond, VA 23219-2901
2. If a middle name is an initial, indicate “initial only” otherwise, enter a full middle name given at birth.
3. For “other names used” list all previous names; nick names, all previous married names, legal name changes,
changes due to adoption, etc. Circle appropriate title description on the form.