ࡱ> y }bjbj 4{{'EF F F F F Z Z Z 8 |!dZ h>r"t''''(Z/1y;}=}=}=}=}=}=$@B=F 6((66=F F ''">p:p:p:6LF 'F 'y;p:6y;p:p::[;'ZZP"7j ;e;8>0h>;C7TC;CF ;L 2)3p:34= 2 2 2==8 2 2 2h>6666C 2 2 2 2 2 2 2 2 2 :  UNAUTHORIZED LEAVE NOTIFICATION1.Child/Youth Status:Michigan Department of Human Services FORMCHECKBOX Permanent Ward, MCI PA 220 FORMCHECKBOX Delinquent Ward, PA 150The DHS-3198 is to be attached to the JC-05 (petition), if filed. FORMCHECKBOX Dual Ward, PA 220 and PA 150The local DHS office is to be notified immediately of the truancy, FORMCHECKBOX Temporary Court Ward, PA 224AWOL, escape.After working hours, weekends and holidays:Notify the local office by calling the 24-hour CPS telephone number.The DHS-3198 is to be faxed or mailed to the local DHS office. If the child/youth is a permanent ward, a copy of the DHS-3198 is to be sent to the MCI superintendent. When the child/youth is found/ apprehended, notify all involved parties.SECTION I - To Be Completed by Reporting Persons:2. Child/Youth Name (Last, First, Middle)3. Date of Birth4. Age FORMTEXT        FORMTEXT       FORMTEXT       FORMTEXT      5. DHS Case Number6. Court File Number7. Date Youth Left Placement8. Time Youth Left Placement FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      9. Other Identifying Feature (Scars, Clothing, Etc.)10. Hair Color11. Eye Color12. Height13. Weight FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      14. Race/Ethnic/Gender Information 15. Risk Assessment (If any, notify law enforcement and explain below:)MFHispanic or Latino FORMCHECKBOX Is serious risk to community/self FORMCHECKBOX Is an escapee, PA 150 com-mitted to high security settingAmerican Indian or Alaskan Native FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  Y  FORMCHECKBOX  N FORMCHECKBOX Is 11 years of age or younger FORMCHECKBOX Foul play is suspectedAsian FORMCHECKBOX  FORMCHECKBOX  FORMTEXT      Black/African American FORMCHECKBOX  FORMCHECKBOX  FORMTEXT      Native Hawaiian/Other Pacific Islander FORMCHECKBOX  FORMCHECKBOX  FORMTEXT      White FORMCHECKBOX  FORMCHECKBOX  FORMTEXT      Unable to Determine FORMCHECKBOX  FORMCHECKBOX 16. Youth May Have Escaped To:17. Name and Relationship18. Phone Number FORMCHECKBOX Parent s Home FORMTEXT        FORMTEXT        FORMTEXT      ( FORMTEXT    )  FORMTEXT      19. Address20. City21. State22. Zip Code FORMCHECKBOX Other: Explain ( FORMTEXT       FORMTEXT       FORMTEXT    FORMTEXT      23. Parent s/Guardian s Name24. Phone Number25. Date Notified of Escape FORMTEXT        FORMTEXT      ( FORMTEXT    )  FORMTEXT       FORMTEXT      26. Parent/Guardian Complete Address27. City28. State29. Zip Code FORMTEXT       FORMTEXT       FORMTEXT    FORMTEXT      30. Name of Placement Agency (Youth Missing From)31. Agency Phone Number FORMTEXT      ( FORMTEXT    )  FORMTEXT      32. Placement Agency Worker s Name33. Date DHS Contacted34. Time DHS Contacted35. Date Notification Mailed FORMTEXT B^`aopq   8 ; r s - 0 \ _   $ & ( 2 4 6 8 L j>h(h U jh(hhUmHnHujuh(h Ujh(h Ujh(h Ujh(h Ujh(h Ujh(h U h(h&; h(h 1!$89_`r-$If'$If]kd$$If9F5+h    4 9a$If*$If |-$If$If$Ifpkd$$If9\5+h4 9a - z-$If$If<$Ifpkd$$If9\5+h4 9a- . q r z-$If$If($Ifpkd $$If9\5+h4 9a :Mkd$$If940+`4 9af4$Ifpkd$$If9\5+h4 9a % & ' ( SMkdX$$If940+ 4 9af4$If  & F$IfMkd$$If940+ 4 9af4( )     e_$IfJkd$$If90+4 9a d$If d$If<kd$$If94`++4 9af4  P Q { $If7kd$$If9++4 9a!$If:kdK$$If94++4 9af4 6 ^ =7$If]kd $$If9F +      4 9a-$If]kd$$If9F +      4 9aL N P Z \ ^ ` t v x N P d f h r t v x ιΫΝΏ΁sjfh(h Uj h(h Uj h(h Uj h(h Uj h(h U h(h&;jx h(h U h(h jh(hhUmHnHujh(h Ujh(h U-  L N v -$Ifpkdg $$If9\  +    4 9a$If Zx$Ifpkd $$If9\  +    4 9a:b{uuuuu-$Ifkd $$If9r, !&+z{z|4 9a(*,68:<PRT^`bdxz| PRWijkyz{ܲܜܓ܌}o}jh(h`iUjh(h`iUh`i h(h`ih(h @j h(h Uh(h 5jh(h UjKh(h Ujh(h U h(h jh(hhUmHnHujh(h U+ QR{uu*Jkd$$If90+4 9a$Ifkdm$$If9r, !&+z{z|4 9aRSUWj|-$If $$Ifa$$If  ./012@ABCDGHVWXYZ[\jklmxjah(h`i@j/h(h`iUjh`iUh`i5OJQJ^Jh`ih`i5OJQJ^JjGh`iUh`ijh`iUjh(h`iUj_h(h`iU h`ih`ih(h`i@jh(h`iU h(h`ijh(h`iU& 1?6-- -$$Ifa$ $Ifgd`ikdu$$If9ִ \ 5 "+ r u     4 9ayt`i1[m$If-$If -$$Ifa$gd`i  >@B^`bdfsj'h(h`iUjh(h`iUj?h(h`iUh`i jh(h`iUmHnHujh(h`iUjyh(h`iUjh(h`iUh$jh(h`iUjh(h`iU h(h`i,=7.. -$$Ifa$$Ifkd$$If9 ִ \ 5 "+ r u     4 9ayt`i7kdR$$If94 ֞ \ (*+ `v`4 9ayt`i-$If$If -$$Ifa$gd`i@d-$If$If -$$Ifa$gd`i -$$Ifa$$If*NPOF::: -$$Ifa$gd`i $Ifgd`ikd$$If94 ֞ \ (*+  v 4 9ayt`i$&(*,HJLRThjlvx(*,HJLNP|nj h(h`iUh`ijh(h`iUjFh(h`iUjh(h`iU jh(h`iUmHnHujph(h`iUjh(h`iUjh(h`iU h(h`ijh(h`iUh`ih`i@+PRz|~>8$Ifkd$$If9 ֞ \ (*+ v4 9ayt`i -$Ifgd`i $Ifgd`i-$If$If -$$Ifa$gd`i -$$Ifa$*NrtPJAA5 -$$Ifa$gd`i -$$Ifa$$Ifkd $$If9 ֞ \ (*+ v4 9ayt`iPlnpx,.0NPdfhrtvxٲΡٓΡمΡwΡijw$h(h Uj#h(h Uj#h(h Uj2#h(h U jh(hhUmHnHuj"h(h UjX"h(h Ujh(h U h(h jh(h`iUj h(h`iU h(h`i)tvx pkd!$$If9 r \ + 4 9ayt`i$If 2N$If-$If]kd!$$If9F +      4 9atv"$&(<>@DFHJ^`blnp  "ܲܤܖ܈rj)h(h Uh(h 5j(h(h Uj'h(h Uj='h(h Uj&h(h U jh`ih`iCJ aJ je&h(h U h(h jh(hhUmHnHujh(h U,2DXr$Ifpkd$$$If9\h +T  4 9art&Hp{ujuuuu <$Ifgd`i-$Ifkd%$$If9r  !&+ Iz|4 9aprhbbb$Ifkd~($$If9ֈh  !&+T Iz|4 9aX=7$If]kd,$$If9F +      4 9a-$If]kdp)$$If9F +      4 9a",.02FHJTVXZ\prtz|^`tvxݹݫݝݏ݁j#.h(h Uj-h(h Uj+h(h Uj+h(h Uj.+h(h Uh(h 5j*h(h U h(h jh(h U jh(hhUmHnHu0.B\^-$Ifpkd%-$$If9\ !&+>z|4 9a$IfbhΪΜΎ··~pj2h(h Uh(h @ h(h&;jq1h(h Uj 1h(h Uj0h(h Uh(h 5j.h(h U h(h jh(hhUmHnHujh(h Uj.h(h U,^=77-$IfJkd,0$$If90 +  4 9a$Ifpkd/$$If9\ !&+>z|4 9a P~=pkd^2$$If9\N$+NNO4 9a$IfJkd1$$If90 +  4 9a       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      36. Name of Reporting Person37. Signature FORMTEXT        FORMTEXT      SECTION II - To Be Completed by DHS Worker:38. Dates and Actions Taken To Locate Missing Youth: FORMTEXT       FORMTEXT      39. DHS Worker Name40. DHS Worker Phone Number FORMTEXT        FORMTEXT      ( FORMTEXT    )  FORMTEXT      41. Name of Law Enforcement Agency Notified42. Date Law Enforcement Notified43. Time Law Enforcement Notified FORMTEXT       FORMTEXT       FORMTEXT      44. Police Report Number45. Police Teletype Number46. Ward Entered On Lien?47. Lien Code Used FORMTEXT       FORMTEXT       FORMCHECKBOX No FORMCHECKBOX Yes ( FORMCHECKBOX 8100 FORMCHECKBOX 002948.All involved parties have been notified that49. Apprehension Date50. Current Placement FORMCHECKBOX youth was found FORMTEXT       FORMTEXT      AUTHORITY: P.A. 150 of 1974 as amended 803.306 COMPLETION: Mandatory PENALTY: Child/Youth a name will not appear on the lien.Department of Human Services (DHS) will not discriminate against any individual or group because of race, religion, age, national origin, color, height, weight, marital status, sex, sexual orientation, gender identity or expression, political beliefs or disability. If you need help with reading, writing, hearing, etc., under the Americans with Disabilities Act, you are invited to make your needs known to a DHS office in your area. Distribution: Law Enforcement, DSW Court, Parent/Guardian, Placement Agency     DHS-3198 (Rev. 9-12) Previous edition obsolete. MSWord pp pppp&p(p*p4p6p8p:pNpPpRp\p^p`pbpvpxpzpppppppppp q q q"q$q.q0q2q4qHqJqLqVqXqZq\qqھڰڢڔچ~h(h 5j7h(h Uj6h(h UjW5h(h Uj4h(h Uj%4h(h Uj3h(h U h(h jh(hhUmHnHujh(h UU18p`pppppq$Ifpkd/6$$If9\N$+NNO4 9a-$Ifq qZq\q^qqc[!<$IfJkdP8$$If90+4 9a-$IfJkd6$$If90+4 9aqq&r(rr@rJrLrPrTrVrjrlrnrxrzr~rrrrrrrrrrss s s s"s$s.s0s4s6sJsLsNsTsVsZs\spsrsts~szj`=h(h Uj<h(h Uju<h(h Uj;h(h UjR:h(h Uh(h 5 jh(hhUmHnHujN9h(h Ujh(h U h(h h(h&;0qq"r$r&rNrPr-$If7kd8$$If9++4 9a$If9kd8$$If9++4 9aPrRrTr|r~rr3bkd:$$If9F*+1*    4 9ayt`i-$Ifbkd9$$If9F*+1*    4 9ayt`irrrr2ssss tdt]Jkd=$$If90+4 9a-$IfJkdU;$$If90+4 9a$If ~sssftht|t~ttttttttttttttttttuuuuuuuuuuuuuuuuvvvvvqj Bh(h 5Ujh(h 5UjAh(h Uj:Ah(h Uj?h(h Uj?h(h U jh(hhUmHnHuj>h(h U h(h h(h 5jh(h U,dtftttttu=7$If]kdD@$$If9F +      4 9a-$If]kd>$$If9F +      4 9auHu|uuuuuvvBvVvzvvv|s| $Ifgd`i$If-$Ifpkd@$$If9\  +    4 9a$If v vv@vBvRvTvVvXvtvvvxvzvvvvvvvtwvwwwwwwwwwwwwwwwwxԛԍԛnԛ`njGh(h U jh(hhUmHnHuj@Fh(h UjEh(h Ujh(h UjhCh(h 5UjBh(h 5U jh`ih`iCJaJ h(h jBh(h 5Uh(h 5jh(h 5U%vvvkdC$$If9 5,{ "!&b'+  O,uA;((((4 9ayt`i$IfvvvwDwpwrwtwwwwxoiiii-$IfkdE$$If9rvF +l  4 9a$If$If xxyt|0}2}6}8}<}>}B}D}H}J}h}j}n}v}}}}}}h`ih`iCJaJh&;h`iCJaJhJjhJUh`ih`ih h(h jh(h Ux x xxnx{u80<$If<kd4H$$If94++4 9af4$IfkdzG$$If9rvF +l  4 9anxxyv|x|,}.}0}4}6}:}b][[[gd`i7kdI$$If9++4 9a$IfOkdH$$If90+4 9ayt$ $Ifgd$$If :}<}@}B}F}H}}}}}gd`i $ d`gd`i 2&P:p`i/ =!"#$% $$If!vh#v#v#vh:V 9555h/ / /  44 9tDeCheck1$$If!vh#v#v#vh#v:V 9555h5/ / 44 9tDeCheck2$$If!vh#v#v#vh#v:V 9555h5/ / 44 9tDeCheck3$$If!vh#v#v#vh#v:V 9555h5/ / 44 9tDeCheck4$$If!vh#v#v#vh#v:V 9555h5/ /  / 44 9S$$If!vh#v:V 94+544 9f4S$$If!vh#v:V 94+544 9f4S$$If!vh#v:V 94+544 9f4R$$If!vh#v+:V 94`5+44 9f4H$$If!vh#v:V 9544 9N$$If!vh#v+:V 945+44 9f4H$$If!vh#v+:V 95+44 9$$If!vh#v#v #v :V 955 5 /  / / 44 9D FirstName2\Enter the Grantee's First Name (and Middle Initial, if known). Then tab to Last Name Field. lastname2D LastName2Enter the Grantee's Last NameD date1#Enter the Date (Example: 4/12/1997)_DText1$$If!vh#v#v #v :V 955 5 / / / 44 9$$If!vh#v #v #v #v :V 95 5 5 5 /  / / 44 9D CaseNumber Uppercase/Enter the Case Number (Example: V1234567A,B,C)_DText2D Date2#Enter the Date (Example: 4/12/1997)bDAllTimes$$If!vh#v #v #v #v :V 95 5 5 5 / / / 44 9$$If!vh#v#vz#v{#vz#v|:V 955z5{5z5|/  / / 44 9_D,Text3D Haircolor#Enter the Date (Example: 4/12/1997)bD EyeColor`D Height`D Weight$$If!vh#v#vz#v{#vz#v|:V 955z5{5z5|/ / / 44 9r$$If!vh#v:V 95/  / / 44 9tDeCheck5tDeCheck5$$If!vh#v #v#v#v#v#vr #vu#v :V 95 55555r 5u5 / / / / 44 9yt`itDeCheck5tDeCheck5tDeCheck9tDeCheck9tDeCheck5tDeCheck5$$If!vh#v #v#v#v#v#vr #vu#v :V 9 5 55555r 5u5 / / / / 44 9yt`itDeCheck5tDeCheck5eD( ExplainRisk$$If!vh#v #v#v#v#vv#v#v:V 94 ++5 5555v55/ / / / 44 9yt`itDeCheck5tDeCheck5fD( ExplainRisk2$$If!vh#v #v#v#v#vv#v#v:V 94 ++5 5555v55/ / / / / 44 9yt`itDeCheck5tDeCheck5fD( ExplainRisk3$$If!vh#v #v#v#v#vv#v#v:V 9 5 5555v55/ / / / / / 44 9yt`itDeCheck5tDeCheck5fD( ExplainRisk3$$If!vh#v #v#v#v#vv#v#v:V 9 5 5555v55/ / / / / / 44 9yt`itDeCheck5tDeCheck5$$If!vh#v #v#v#v#v:V 9 5 5555/ / /  / 44 9yt`i$$If!vh#v #v#v :V 95 55 /  / /  44 9tDeCheck6fD FirstNameAlleD LastNameAllfD RelationshipzDAreaCodelD AllTelephoneNumber$$If!vh#v#vT #v#v :V 955T 55 / / / / / 44 9$$If!vh#v #vI#v#vz#v|:V 95 5I55z5|/  / / /  / 44 9tDeCheck6dD AllAddressaD AllCitybDAllState~D AllZipCode$$If!vh#v#vT #vI#v#vz#v|:V 955T 5I55z5|/ / / /  / / / 44 9r$$If!vh#v#v #v :V 955 5 /  44 9DParentNameFirst\Enter the Grantee's First Name (and Middle Initial, if known). Then tab to Last Name Field.DParentNameLastEnter the Grantee's Last NamecD AreaCode2fD PhoneNumber2D Date3#Enter the Date (Example: 4/12/1997)r$$If!vh#v#v #v :V 955 5 / 44 9$$If!vh#v>#v#vz#v|:V 95>55z5|/  / 44 9nD7ParentGuardianAddreslD ParentGuardianCitymDParentGuardianStateDParentGuardianZipCod$$If!vh#v>#v#vz#v|:V 95>55z5|/ / / 44 9r$$If!vh#v #v :V 95 5 /  / 44 9iDDPlacementAgencyhDAgencyAreaCodekD AgencyPhoneNumber$$If!vh#v #v :V 95 5 / / / 44 9r$$If!vh#v#vN#vO:V 955N5O/  44 9DPlacmentAgencyFirst\Enter the Grantee's First Name (and Middle Initial, if known). Then tab to Last Name Field.DPlacementAgencyLastEnter the Grantee's Last NameD DateFIAContacted#Enter the Date (Example: 4/12/1997)bDAllTimesD DateNotificationMail#Enter the Date (Example: 4/12/1997)r$$If!vh#v#vN#vO:V 955N5O/ 44 9V$$If!vh#v:V 95/  44 9DFirstNameReportingPe\Enter the Grantee's First Name (and Middle Initial, if known). Then tab to Last Name Field.DLastNameReportingPerEnter the Grantee's Last NameV$$If!vh#v:V 95/ 44 9L$$If!vh#v+:V 95+44 9V$$If!vh#v+:V 95+/  44 9jDXDatesandActions1$$If!vh#v#v1*#v:V 9551*5/ / / 44 9yt`iiDXDatesandAction2$$If!vh#v#v1*#v:V 9551*5/ /  / 44 9yt`iV$$If!vh#v:V 95/  44 9DFIAWorkerFirstName\Enter the Grantee's First Name (and Middle Initial, if known). Then tab to Last Name Field.DFIAWorkerLastNameEnter the Grantee's Last NamecD AreaCode2fD PhoneNumber2V$$If!vh#v:V 95/ 44 9r$$If!vh#v#v #v :V 955 5 /  44 9nD-LawEnforcementAgencyD DateLawEnforcementNo#Enter the Date (Example: 4/12/1997)lDTimeLawEnforcementr$$If!vh#v#v #v :V 955 5 / 44 9$$If!vh#v #v #v #v :V 95 5 5 5 /  44 9lDPoliceReportNumberfD PoliceNumbertDeCheck7tDeCheck7tDeCheck7tDeCheck74$$If!v h#v #v #v#v#vO#v,#vu#v#v A#v ;:V 9,5 5 555O5,5u55 A5 ;/ / / / / / /  44 9yt`i$$If!vh#v#v#vl#v #v :V 9555l5 5 / /  / / 44 9tDeCheck8D ApprehensionDate#Enter the Date (Example: 4/12/1997)jDCurrentPlacement$$If!vh#v#v#vl#v #v :V 9555l5 5 / / / / 44 9R$$If!vh#v+:V 945+44 9f4$$If!vh#v#v:V 9,55/ /  / 44 9yt$H$$If!vh#v+:V 95+44 9^; 2 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH 8`8 Normal_HmH sH tH DA D Default Paragraph FontVi@V  Table Normal :V 44 la (k (No List POP BLANKLINEdx5CJOJQJkHTOT Captions 6ptd(CJ OJQJkHDOD Captions 6pt bold5`O"` Captions 6pt boxd<5CJ OJQJkHD2D Captions 6pt Nbox<DOBD Captions 7pt dtCJDOARD Captions 7pt Bold5BOqbB Captions 7pt box5^Or^ Captions 7pt NBoxdt<CJOJQJkHPOP Captions 8pt d`CJOJQJkH^O^ Captions 8pt Bold d`5CJOJQJkHFF Captions 8pt box <DD Captions 8pt NboxPPOP Captions 9pt dLCJOJQJkHJOJ Captions 9pt BolddLCJFOF Captions 9pt Box dDOD Captions 9pt Nbox5POP Captions 10pt d`( OJQJkH^O^ Captions 10pt Bold!d`(5OJQJkHXO"X Captions 10pt box"d`P OJQJkHHO2H Captions 10pt Nbox#P5J @BJ Footer$dt !CJOJQJkHRORR Form Title 10pt%$d8a$ OJQJkH^Ob^ Form Title 10pt Bld&$d8a$5OJQJkHVOrV Form Title 11pt'$d$a$CJOJQJkHLOaL Form Title 11pt Bld(d$CJVOV Form Title 12pt)$da$CJOJQJkHbOb Form Title 12pt Bld*$da$5CJOJQJkH44 Header + !HOH Small Blank Line ,CJXOX User Input 10pt-d8(5OJQJkHTOT User Input 11pt.d$5CJOJQJkH\O\ User input 12pt/d((5CJOJQJkHTOT Letter Text 10pt0$d$a$ OJQJkHFOF Letter Text 11pt1dCJXO"X Letter Text 12pt2$da$CJOJQJkHL2L Captions 10pt 2 line 3<FOBF Date 08pt45CJOJQJkH6OAR6 Date 09pt5CJ6OAb6 Date 10pt6CJ2Oar2 Date 11pt7CJ.). &; Page NumberH@H :& Balloon Text9CJOJQJ^JaJNoN 9&Balloon Text CharCJOJQJ^JaJPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭V$ !)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu gZo~ٺlAplxpT0+[}`jzAV2Fi@qv֬5\|ʜ̭NleXdsjcs7f W+Ն7`g ȘJj|h(KD- dXiJ؇(x$( :;˹! I_TS 1?E??ZBΪmU/?~xY'y5g&΋/ɋ>GMGeD3Vq%'#q$8K)fw9:ĵ x}rxwr:\TZaG*y8IjbRc|XŻǿI u3KGnD1NIBs RuK>V.EL+M2#'fi ~V vl{u8zH *:(W☕ ~JTe\O*tHGHY}KNP*ݾ˦TѼ9/#A7qZ$*c?qUnwN%Oi4 =3N)cbJ uV4(Tn 7_?m-ٛ{UBwznʜ"Z xJZp; {/<P;,)''KQk5qpN8KGbe Sd̛\17 pa>SR! 3K4'+rzQ TTIIvt]Kc⫲K#v5+|D~O@%\w_nN[L9KqgVhn R!y+Un;*&/HrT >>\ t=.Tġ S; Z~!P9giCڧ!# B,;X=ۻ,I2UWV9$lk=Aj;{AP79|s*Y;̠[MCۿhf]o{oY=1kyVV5E8Vk+֜\80X4D)!!?*|fv u"xA@T_q64)kڬuV7 t '%;i9s9x,ڎ-45xd8?ǘd/Y|t &LILJ`& -Gt/PK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!0C)theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] m DDDGL P"q~svx}"'+.35?BFIL- (  R1Pt rpqqPrrdtuvvxnx:}} !#$%&()*,-/012467@ACDEGHJKMNO`prHTZ\hnp|"(*6<>JPR^d ?O ,<\ln~"$48DJTdfvz & 6 B H J V \ ^ j p s     " . 1 3 ? E > J P R ^ d f r u w   & ( 4 :   &)59<HNamsuIYkw}mG$G$G$G$FFFTFFFFTFFFFFFG$G$G$G$G G$G$G$G$G$FG$G$FG$G$FG$G$FG$G$G$FFFFTFG$FFFFTFFFFFTFFFFTFFFFFFTFFTFFFFFFFFFFTFFFG$G$G$G$G$FTF8@0(  B S  ?>Check1Check2Check3Check4 FirstName2 LastName2date1Text1 CaseNumberText2Date2Text3 HaircolorEyeColorHeightWeightCheck9 ExplainRisk ExplainRisk2 ExplainRisk3Check6 FirstNameAll LastNameAll RelationshipAreaCodeAllTelephoneNumber AllAddressAllCityAllState AllZipCodeParentNameFirstParentNameLast AreaCode2 PhoneNumber2Date3ParentGuardianAddresParentGuardianCityParentGuardianStateParentGuardianZipCodPlacementAgencyAgencyAreaCodeAgencyPhoneNumberPlacmentAgencyFirstPlacementAgencyLastDateFIAContactedAllTimesDateNotificationMailFirstNameReportingPeLastNameReportingPerDatesandActions1DatesandAction2FIAWorkerFirstNameFIAWorkerLastNameLawEnforcementAgencyDateLawEnforcementNoTimeLawEnforcementPoliceReportNumber PoliceNumberCheck7Check8ApprehensionDateCurrentPlacementasI]q+?S{ 7 K _ t  # 4 ? S g x  ) bvJln  !"#$%&'()*+,-./0123456789:;<=q[o)=Qe' I ] q ! 2 F Q e v  ' ; 'tZ~n          µ õ ĵ ŵ Ƶ ǵ ȵ ɵ ʵ ˵    ! & & * n      % % ) / / n   9*urn:schemas-microsoft-com:office:smarttagsplace;*urn:schemas-microsoft-com:office:smarttagsaddress=*urn:schemas-microsoft-com:office:smarttags PlaceName= *urn:schemas-microsoft-com:office:smarttags PlaceType:*urn:schemas-microsoft-com:office:smarttagsStreet9*urn:schemas-microsoft-com:office:smarttagsState8*urn:schemas-microsoft-com:office:smarttagsCity `    &')*,-/023kn')*,-/023kn333 U[Swx ab&')*,-/023in U[Swx aa&'()*+,-./012BCDFiin*0 7@h h^h`OJQJo(   hJvo!&;Ad?`i{&DVZ($')V 44  Spell Check Spell CheckQ+Q+Q+Q+Q+1(  Spell CheckForms Spell Check2Module1.FormsSpellCheck2g Project.Module1.FormsSpellCheck2 PROJECT.MODULE1.FORMSSPELLCHECK2@ `q``| m@  @pUnknownG* Times New Roman5Symbol3. * Arial?Wingdings 3?= * Courier New5. *aTahomaA$BCambria Math"h R ' R 'Q 'L "L "r c#24UL\2QHX ?{*!xx]Z_A Unauthorized Leave NotificationForms & Mail ManagementAllison R. Beckman Oh+'0  (4 T ` l x Unauthorized Leave NotificationForms & Mail Management 3198.dotAllison R. Beckman2Microsoft Office Word@@007F@FP@FPL՜.+,0, hp  (Michigan Department of Human Services"   Unauthorized Leave Notification Title  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuwxyz{|}~Root Entry Fg_ZPData QdI1TablevCWordDocument4SummaryInformation(DocumentSummaryInformation8Macros ZZPZZPVBA ZZPZZPdirModule1 ThisDocument &_VBA_PROJECT6a   !"#$%'()*+,-./012345789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_abcdefhj0* pHdProjectQ(@= l XM< J< rstdole>stdoleP h%^*\G{00020430-C 0046}#2.0#0#C:\WINDOWS\system32\e2.tlb#OLE Automation`EOfficEOficEE2DF8D04C-5BFA-101B-BDE5EAAC42Egram Files\@CommonMicrosoft Shared\OFFICE11\MSO.DLL#M 11.0 Ob LibraryKӈThisDocumentGTisDcumon]* 2  HB1Bx%B,!"B+BModule1GM!d!|1m 2ObM,M!C\MxME(<"<< <h  X%"  .@Pp &x  (((P X h]@'If document is protected, Unprotect it. $!& (cladd87, $B@*MrbigkPerform Spelling/Grammar check.e .(0iat  $!2 !4(6: !4B@8  ReProtect the document. $!& (cladd87,> @l $B@<koAttribute VB_Name = "Module1" Sub FormsSpellCheck2() Dim x As wdNo Then  9ZPassword:="c@ladd87E nd If'P(erf ing/Gramma8r clK.Op2tBs.vWi thFalse EachIn JsZx.Range.iof>$;;5AlwaysSuggest :=Tru; Next: 'Re the=&EW, n orese&, o:=wdAllowOnlyAbAAe#xME (SLSS<N0{00020906-0000-0000-C000-000000000046}8(%HxAttribute VB_Name = "ThisDocument" Bas0{00020P906-0C$0046} |GlobalSpacFalse dCreatablPredeclaIdTru BExposeTemplateDerivBustomizD2ay  *\G{000204EF-0000-0000-C000-000000000046}#4.0#9#C:\PROGRA~1\COMMON~1\MICROS~1\VBA\VBA6\VBE6.DLL#Visual Basic For Applications*\G{00020905-0000-0000-C000-000000000046}#8.3#0#C:\Program Files\Microsoft Office\OFFICE11\MSWORD.OLB#Microsoft Word 11.0 Object Library*\G{00020430-0000-0000-C000-000000000046}#2.0#0#C:\WINDOWS\system32\stdole2.tlb#OLE Automation(*\G{2DF8D04C-5BFA-101B-BDE5-00AA0044DE52}#2.3#0#C:\Program Files\Common Files\Microsoft Shared\OFFICE11\MSO.DLL#Microsoft Office 11.0 Object Library XM<ThisDocument1s4dc1584dThisDocument%Module11z4dc15877Module1Mb84GB|rOJ}َZGG>(H !(WordkVBAWin16~Win32MacVBA6#Project1 stdole`Project- ThisDocument< _EvaluateTemplateProjectEOfficeuDocumentjModule1bFormsSpellCheck2gzxo FormFieldActiveDocument\ProtectionTypewdNoProtection Unprotect?PasswordOptionsCheckGrammarWithSpelling FormFields-|Range  NoProofing] CheckSpellingW AlwaysSuggestProtectfnoresetgwdAllowOnlyFormFields!T  $PROJECT `PROJECTwmgACompObjirID="{32295250-486C-4B94-8C89-D4FA1EB4E3E1}" Document=ThisDocument/&H00000000 Module=Module1 Name="Project" HelpContextID="0" VersionCompatible32="393222000" CMG="A8AA7D7B817B817B817B81" DPB="5052852686268626" GC="F8FA2DCE2ECE2E31" [Host Extender Info] &H00000001={3832D640-CF90-11CF-8E43-00A0C911005A};VBE;&H00000000 [Workspace] ThisDocument=0, 0, 0, 0, C Module1=0, 0, 0, 0, C ThisDocumentThisDocumentModule1Module1  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q