In order to receive benefits through the Ohio Department of Job and Family Services (ODJFS), you must complete Form JFS 01695. This form is used to establish your eligibility for assistance, and it must be completed and submitted to ODJFS in order to receive benefits. The form is simple to complete, and it only takes a few minutes to fill out. In this blog post, we will walk you through the steps required to complete Form JFS 01695. We will also provide some tips on how to ensure that your application is processed as quickly as possible. So, let's get started!
| Question | Answer |
|---|---|
| Form Name | Form Jfs 01695 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | DHS_1695_Applic ation_For_Searc h putative father registry search ohio form |
Ohio Department of Job and Family Services
APPLICATION FOR SEARCH OF OHIO PUTATIVE FATHER REGISTRY
Ohio Putative Father Registry
P.O. Box 182709
Columbus, Ohio
Phone:
Please perform a search of the Ohio Putative Registry. Please advise if a Putative Father Registration form is on file with respect to the mother, child or father identified below.
SECTION I: IDENTIFYING INFORMATION ABOUT THE MOTHER
Mother's LAST Name
FIRST Name
MIDDLE Name
Social Security Number |
Phone Number |
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Date of Birth (MM/DD/YY) |
Race |
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Other names by which mother may be known |
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3. |
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2. |
4. |
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Home Address |
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City
State
Zip Code
Mother's Mailing Address/Apt. (If different than above)
City
State
Zip Code
SECTION II: IDENTIFYING INFORMATION ABOUT THE FATHER
Father's LAST Name
FIRST Name
MIDDLE Name
Social Security Number |
Phone Number |
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Date of Birth (MM/DD/YY) |
Race |
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Other names by which father may be known |
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1. |
3. |
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2. |
4. |
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Home Address |
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City
State
Zip Code
Father's Mailing Address/Apt. (If different than above)
City
State
Zip Code
JFS 01695 (Rev. 3/2008) |
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SECTION III: IDENTIFYING INFORMATION ABOUT THE CHILD
Child's LAST Name |
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FIRST Name |
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MIDDLE Name |
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Race |
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Sex |
Male |
Female |
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Estimated Due Date of Mother (MM/YY) |
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Child's Date of Birth (MM/DD/YY) |
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Child's Birthplace |
City |
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State |
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Hospital name, if any |
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Birth Certified
Yes
No
Multiple Birth
Yes
No
SECTION IV: INFORMATION ABOUT INTERESTED PARTY REQUESTING SEARCH OF REGISTRY
Name of Firm or Agency (if applicable)
Name of Person(s) Requesting Search
Phone Number
Fax Number
Person Requesting Search is
Attorney Arranging Adoption of Minor
Attorney Representing Mother of Minor Mother of Child
Private Child Placing Agency (PCPA) or Attorney Representing PCPA Public Children Services Agency (PCSA) or Attorney Representing PCSA
Address for Notice of Search Results
City
State
Zip
I certify that the information provided in this Search Request Form is true and correct to the best of my knowledge. I further certify that I am requesting this search of the Putative Father Registry to determine whether a putative father is registered in relation to the child referenced above, who is or may be the subject of an adoption petition, and the information obtained will be used for this purpose only.
Signature of Individual Requesting Search
Date
SECTION V: TO BE COMPLETED BY THE OHIO PUTATIVE FATHER REGISTRY
Date Request Received (MM/DD/YY)
ODJFS Staff
Search Request Record Locator Number
Outcome
JFS 01695 (Rev. 3/2008) |
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