Form 06-9778 "Office of Children's Services Records Request" - Alaska

What Is Form 06-9778?

This is a legal form that was released by the Alaska Department of Health and Social Services - a government authority operating within Alaska. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2021;
  • The latest edition provided by the Alaska Department of Health and Social Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 06-9778 by clicking the link below or browse more documents and templates provided by the Alaska Department of Health and Social Services.

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Download Form 06-9778 "Office of Children's Services Records Request" - Alaska

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OFFICE OF CHILDREN’S SERVICES RECORDS REQUEST
Please complete and submit this form to
hss.ocs.records.request@alaska.gov
or print and mail to
Office of Children’s Services, PO BOX 110630, Juneau, AK 99811-0630
Use this form to request copies of OCS records. External record requests will need a completed Release
of Information from the individual(s) whose records are being released. State agencies require a cover
letter on the agency's letterhead. Civil and Criminal Court Requests will need a court Motion,
Subpoena, or Order for Release of OCS records. Custody records require a court order for records
during the time-period in which the individual(s) was in custody.
OCS will make every effort to complete this request within thirty (30) days. Please note that the length
of time from initial date of case, type of request and circumstances surrounding the request varies and
OCS cannot guarantee that your records will be available. You will be notified if your records cannot
be located. If you have questions about this form, please email
hss.ocs.records.request@alaska.gov
INCOMPLETE REQUESTS AND LACK OF REQUIRED DOCUMENTATION WILL DELAY
PROCESSING
REQUESTOR INFORMATION
NAME LAST
FIRST
MIDDLE
DOB
TITLE
ORGANIZATION OR BUSINESS NAME IF APPLICABLE
DRIVER’S LICENSE OR OTHER PICTURE ID#
(ATTACH COPY TO REQUEST)
MAILING ADDRESS
CITY
STATE
ZIP CODE
TELEPHONE NUMBER
FAX NUMBER (INCLUDE AREA CODE)
EMAIL ADDRESS
(INCLUDE AREA CODE)
SEND TO (IF SOMEONE OTHER THAN YOURSELF)
NAME AND ADDRESS
REQUEST TYPE
☐ ORCA/PROBER FILE (INTERNAL USE), NUMBER _____________
☐ PERSONAL (FOSTER/ADOPTION) RECORDS
☐ OUT OF STATE CHILD PROTECTIVE SERVICES REQUEST
☐ OTHER: _________________________
☐ ADAM WALSH CHECK
☐ FACILITY/PROVIDER RECORDS
☐ CIVIL/CRIMINAL COURT PROCEEDINGS
REQUESTING
☐ RECORDS DESCRIBED ON ATTACHMENT
☐ THE FOLLOWING RECORDS:
☐ ALL RELEASABLE OCS RECORDS
☐ OTHER: _____________________________
OFFICE OF CHILDREN’S SERVICES RECORDS REQUEST
Please complete and submit this form to
hss.ocs.records.request@alaska.gov
or print and mail to
Office of Children’s Services, PO BOX 110630, Juneau, AK 99811-0630
Use this form to request copies of OCS records. External record requests will need a completed Release
of Information from the individual(s) whose records are being released. State agencies require a cover
letter on the agency's letterhead. Civil and Criminal Court Requests will need a court Motion,
Subpoena, or Order for Release of OCS records. Custody records require a court order for records
during the time-period in which the individual(s) was in custody.
OCS will make every effort to complete this request within thirty (30) days. Please note that the length
of time from initial date of case, type of request and circumstances surrounding the request varies and
OCS cannot guarantee that your records will be available. You will be notified if your records cannot
be located. If you have questions about this form, please email
hss.ocs.records.request@alaska.gov
INCOMPLETE REQUESTS AND LACK OF REQUIRED DOCUMENTATION WILL DELAY
PROCESSING
REQUESTOR INFORMATION
NAME LAST
FIRST
MIDDLE
DOB
TITLE
ORGANIZATION OR BUSINESS NAME IF APPLICABLE
DRIVER’S LICENSE OR OTHER PICTURE ID#
(ATTACH COPY TO REQUEST)
MAILING ADDRESS
CITY
STATE
ZIP CODE
TELEPHONE NUMBER
FAX NUMBER (INCLUDE AREA CODE)
EMAIL ADDRESS
(INCLUDE AREA CODE)
SEND TO (IF SOMEONE OTHER THAN YOURSELF)
NAME AND ADDRESS
REQUEST TYPE
☐ ORCA/PROBER FILE (INTERNAL USE), NUMBER _____________
☐ PERSONAL (FOSTER/ADOPTION) RECORDS
☐ OUT OF STATE CHILD PROTECTIVE SERVICES REQUEST
☐ OTHER: _________________________
☐ ADAM WALSH CHECK
☐ FACILITY/PROVIDER RECORDS
☐ CIVIL/CRIMINAL COURT PROCEEDINGS
REQUESTING
☐ RECORDS DESCRIBED ON ATTACHMENT
☐ THE FOLLOWING RECORDS:
☐ ALL RELEASABLE OCS RECORDS
☐ OTHER: _____________________________
REQUESTING RECORDS FOR
☐ SELF
☐ OTHER (FILL OUT THIS PORTION)
NAME LAST
FIRST
MIDDLE
FORMER NAMES
DATE OF BIRTH
RELATIONSHIP TO REQUESTOR
IF I AM NOT THE PERSON WHO IS THE SUBJECT OF CONFIDENTIAL RECORDS, I AM AUTHORIZED TO ACCESS THESE
RECORDS BECAUSE I AM THE:
☐ PARENT OF MINOR
☐ LEGAL GUARDIAN
☐ PERSONAL OR ESTATE REPRESENTATIVE
☐ OTHER:
BY SIGNING THIS FORM, I AM ATTESTING THAT THE FORM HAS BEEN COMPLETED ACCURATELY TO MY
KNOWLEDGE AND THAT THE FOLLOWING DOCUMENTS ARE ATTACHED
☐ RELEASE OF INFORMATION SIGNED BY PARTIES
☐ ID/BADGE OF REQUESTOR
☐ COVER LETTER
☐ COURT ORDER
☐ OTHER:
____________________________
REQUESTED BY (SIGNATURE)
DATE
PRINTED NAME
NOTARY SIGNATURE, STATE AND COMMISSION EXPIRATION DATE
DATE
PRINTED NAME
NOTARY STAMP
OFFICE USE ONLY
DATE RECEIVED
RECEIVED BY
REQUEST
RESPONSE TO REQUESTOR
APPROVED/DENIED
RECORDS REQUESTED
RECORDS
RECORDS PRODUCED
SIGNATURE ONCE COMPLETED
TO REQUESTOR
RECEIVED
RETURN RECORDS TO
FIELD OFFICE
ARCHIVE LOCATION
RECORDS RETURNED
06-9778 ADMIN (Revised 03/2021)
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