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Issue / 17-43 / Date: / 12/06/17DMV REQUEST FOR CONFIDENTIALITY OF HOME ADDRESS
Childabuseinvestigatorsorsocialworkers,working inchildprotective serviceswithina socialservicesdepartment are eligible for Confidentiality of Home Address. Only those with the job title of DCFS Children’s Social Worker and their spouse/registered domestic partner and/or child(ren), are eligible for Confidentiality of Home Address. A Children’s Social Worker Intern or Supervising Children’s Social Worker are not eligible for Confidentiality of Home Address.
In order to obtain confidentiality, the DCFS Children’s Social Worker must complete the INV 32 form which must be requested from your office Staff Assistant.
EMPLOYEE’S RESPONSIBILITY
SECTION 1: EMPLOYEE INFORMATION
Please enter the nameexactlyasshownontheDU/IDcard,CAdriverlicensenumberandmailingaddress.PLEASE DO NOT ABBREVIATE.
- Checkallappropriateboxes. Ifonlythedriverlicenserecordofthequalifyingemployeeistobeupdated,continuetotheQualifyingEmployeeInformationsection.
Enterthename(s)exactlyasshownontheDU/IDcardfor the spouse/registereddomesticpartnerand/orchild(ren)andallvehiclelicenseplatenumberstobeupdated.
Note:Onlyaspouse/registereddomesticpartnerandchildrenareeligibleforconfidentialityof homeaddress. Vehiclesmustberegisteredineitherthequalifyingemployeeor eligible familymember'sname.
ForrequestsmadeonorafterJanuary1,2011,thepersonrequestingconfidentialityfortheirspouseorchildshalldeclare,at thetime oftherequestforconfidentiality,whetherthespouseorchildhasbeenconvictedofacrimeandisonactiveparoleorprobation.
SECTION 3: QUALIFYING EMPLOYEE INFORMATION
Onlyone(1)qualifyingagencymaybeupdated.
- CompleteSectionC.
- Fill inthecountynameandchecktheappropriatebox.
- Since DCFS isnotlisted,markBox75(Other)inSectionDandfillinthecounty,agencynameandcity. (Los Angeles County Department of Children and Family Services, Los Angeles)
- To complete the agencyaddress portion, please enter the following DCFS Headquarters Agency physical address:
- Supervisor name and signature
- Please do not use white-out, correction tape or cross out any information when completing this form.
Human Resources
425 Shatto Place
Los Angeles, CA 90020
Attention: Personnel Processing
ADDITIONAL INFORMATION
Upon the employees’ change of classification or separation from DCFS, the Personnel Processing section will submit a request for removal of the confidential license plate with the State of California. The yellowcopyoftheINV32is toberetainedbyPersonnel Processingin theemployee'spersonnelfile. Uponterminationofemployment,theyellowcopywill beforwardedtotheConfidentialRecordsUnit.
Thereisnoneedtonotifythe DMVwhenavehiclewithconfidentialityhasbeensold. Upon transferintothenewowner'sname,theconfidentialitywillautomaticallybedeleted. The confidentialitywillmovewiththepriorowner’sinformation.
/ If you have any questions regarding this release please
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