background shadows

NJ DCF Logo with reverse copy

 

New Jersey Department of Children and Families Policy Manual

 

Manual:

CP&P

Child Protection and Permanency

Effective Date:

Volume:

X

Forms

Chapter:

A

Forms

12-21-2009

Subchapter:

1

Forms

Issuance:

21.8

CP&P Form 21-8, Certification of Documents

 

 

Click here to view or print CP&P Form 21-8, Certification of Documents.

 

WHEN TO USE IT

 

CP&P Form 21-8, the Certification of Documents form, is required in any Title 9 hearing when any writing, record, or photograph made or obtained in the regular course of business of a hospital or agency is to be introduced as evidence, N.J.S.A. 9:6-8.46 (3).  This document serves to attest to the fact that such records were, in fact, made in the regular course of business.

 

HOW TO USE IT

 

The hospital or agency Director or designee completes the form in duplicate, as guided by the Worker.  The assigned Worker, or the person authorized to sign the form, enters the appropriate information in the blanks in the body of the form.  The form must be signed by the Director of the agency or hospital, or his or her designee.

When the hospital or agency Director delegates the authority to certify documents to another employee, this designation is entered in Paragraph 2.  In such matters, the signatures of both the Director and the employee to whom authority is delegated are required.

The assigned Worker gives this form (both copies) to any hospital or agency from which the Division is requesting records, and provides an explanation of its use.  Request that the form be completed, signed, and returned with the requested documents.  The Worker advises that the hospital or agency may retain the second copy of the form for its records.

Whenever the form is needed to document a piece of evidence, a photocopy may be made from the original.  File the original in the case record upon receipt, attached to the requested material.

 

DISTRIBUTION

 

Original

-

Child's case record, attached to requested hospital report or other material/evidence

2nd Original

-

Hospital Director/designee, or hospital/agency record or patient chart