CP&P 21-7
(rev. 12/2012)
REQUEST FOR INFORMATION PURSUANT TO N.J.S.A. 9:6-8.40
[Date Mailing Letter]
To:
[Name and Title]
[Address]
[City]
Re:
[Child's Name]
[Address]
[City]
[Parent's Name]
[Address]
[City]
____________________________________________________________________________________________________
Under the New Jersey Child Abuse Law N.J.S. A. 9:6-8.40 et seq., when the Division of Child Protection and
Permanency receives a report that a child may be abused or neglected, the Division may request from all public or
private institutions or agencies, including private practitioners, any records, past and present, pertaining to that
child and other children under the same care, custody and control. The Division shall not be charged a fee for the
copying of the records. These records may be released to the Division to aid in evaluation to determine if the child
is abused or neglected. In the release of the above-mentioned records, you shall have immunity from any liability,
civil or criminal, resulting from the release of these records.
Pursuant to the authority of N.J.S.A. 9:6-8.40 et seq., the Department of Children and Families, Division of
Child Protection & Permanency requests your assistance in providing any and all information or records you may
have on the above-named child(ren). This request is being made pursuant to an abuse and/or neglect investigation.
Thank you for your cooperation.
Sincerely,
CP&P Worker
[Local/IAIU Office]
[Address]
[City]
[Telephone]