Out-Of-State Disclosure - Criminal Record Statement Template
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4REASON FOR THIS TRANSMITTAL
April 20, 2010
[ ] State Law Change
[ ] Federal Law or Regulation
Change
[ ] Court Order
ALL COUNTY INFORMATION NOTICE NO. I-30-10
[ ] Clarification Requested by
One or More Counties
[X] Initiated by CDSS
TO:
ALL COUNTY WELFARE DIRECTORS
ALL CHILD WELFARE SERVICES PROGRAM MANAGERS
ALL CHIEF PROBATION OFFICERS
ALL TITLE IV-E AGREEMENT TRIBES
SUBJECT:
RELATIVE ASSESSMENT/APPROVAL PROCESS - REVISIONS TO
THE OUT-OF-STATE DISCLOSURE AND CRIMINAL RECORD
STATEMENT (LIC 508 D) FORM
REFERENCE: MARIJAUANA REFORM ACT OF 1977, HEALTH AND SAFETY CODE
(H&S) SECTION 11361.5 AND 11361.7
The purpose of this All County Information Notice (ACIN) is to notify counties
conducting relative and Nonrelative Extended Family Member (NREFM) caregiver
background checks that the Out-Of-State Disclosure & Criminal Record Statement (LIC
508 D) form has been revised. This form was modified, October 2009, to reflect that
certain marijuana-related offenses covered by the Marijuana Reform Act do not need to
be disclosed as outlined in H&S Code, sections 11361.5 and 11361.7. The required
updated LIC 508 D form can be found at the following internet website address:
The Marijuana Reform Act of 1977 provides that criminal records related to minor
marijuana convictions, or arrests, which are over two years old, shall not be considered
to be relevant for any purpose by any public agency or person, and shall be destroyed
by the California Department of Justice. Individuals who obtain the protections of these
laws may, two years from the date of the conviction or arrest that did not result in a
conviction, indicate in response to any question concerning their prior criminal record
that he/she was not arrested or convicted of such offense. Therefore, the California
Department of Social Services is required to disregard all convictions and conduct
associated with the marijuana convictions listed below.
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