CP&P 26-15 (rev. 10/2006) State of New Jersey DEPARTMENT OF CHILDREN AND FAMILIES Division of Child Protection and Permanency AUTHORIZATION FOR RELEASE OF INFORMATION I authorize (Name of agency or person) to release information to (Name of agency or person) about me or my children, (Print name of person(s) authorizing release, and/or children) Signature Signature Date Agency Representative Date Telephone Local Office Address/Sponsoring Agency Address CP&P adheres to existing laws and regulations regarding releasing or obtaining information about its clients. (Administrative Order 2:01, N.J.S.A. 30:4-24.3 and N.J.S.A. 9:6-8.10a). CP&P requires agencies receiving information from CP&P to respect the confidential nature of the material and to be aware that there may be penalties for release of such information to unauthorized persons. When a child is placed through CP&P, information regarding the child’s placement is shared with the Family Court and the Child Placement Review Board.