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00218316470010101
PENNSYLVANIA CHILD ABUSE
HISTORY CERTIFICATION
CERTIFICATION ID: WWPJ78EKFZ
CERTIFICATION PURPOSE: EMPLOYMENT
VERIFICATION DATE: 7/25/2016
SOCIAL SECURITY #: XXX-XX-2524
DATE OF BIRTH: 4/26/1996
CARLA M. ZIMMERMAN
614 CENTRAL AVE
FEASTERVILLE, PA 19053
The above named person has applied for a Pennsylvania Child Abuse History
Certification pursuant to 23 Pa. C.S., Chapter 63 related to the Child Protective
Services Law. NO RECORDS EXIST in the Pennsylvania Department of Human
Services' Statewide database listing the applicant as a perpetrator of an Indicated or
Founded report of child abuse.
Applicants are required to show the Administrator the results of their
Child Abuse History Certification. Administrators are required to keep a
copy of this Child Abuse History Certification on file. Any person altering
the contents of this document may be subject to civil, criminal or
administrative action.
ISSUED BY Commonwealth of Pennsylvania
Department of Human Services
CHILDLINE AND ABUSE REGISTRY
ChildLine Verification Unit
P.O. Box 8170
Harrisburg, PA 17105-8170
1-877-371-5422
04639O CY893O - 6/00
Child Abuse clearance.PDF

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Child Abuse clearance.PDF

  • 1. 00218316470010101 PENNSYLVANIA CHILD ABUSE HISTORY CERTIFICATION CERTIFICATION ID: WWPJ78EKFZ CERTIFICATION PURPOSE: EMPLOYMENT VERIFICATION DATE: 7/25/2016 SOCIAL SECURITY #: XXX-XX-2524 DATE OF BIRTH: 4/26/1996 CARLA M. ZIMMERMAN 614 CENTRAL AVE FEASTERVILLE, PA 19053 The above named person has applied for a Pennsylvania Child Abuse History Certification pursuant to 23 Pa. C.S., Chapter 63 related to the Child Protective Services Law. NO RECORDS EXIST in the Pennsylvania Department of Human Services' Statewide database listing the applicant as a perpetrator of an Indicated or Founded report of child abuse. Applicants are required to show the Administrator the results of their Child Abuse History Certification. Administrators are required to keep a copy of this Child Abuse History Certification on file. Any person altering the contents of this document may be subject to civil, criminal or administrative action. ISSUED BY Commonwealth of Pennsylvania Department of Human Services CHILDLINE AND ABUSE REGISTRY ChildLine Verification Unit P.O. Box 8170 Harrisburg, PA 17105-8170 1-877-371-5422 04639O CY893O - 6/00