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Get Nd Sfn 960 2001

Tion Name of Parent(s)/Caretaker Address City State Zip Code Telephone Number Name of Subject (Person(s) Suspected to be Causing Maltreatment) Address City State Zip Code Telephone Number Give nature and extent of the suspected abuse or neglect, including any information of previous abuse or neglect; family composition; and any other information which may be helpful in protecting the health and welfare of the child(ren). If additional space is needed, attach additional pages (BE SPECIFIC.

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