The sending agency shall thereafter
furnish the Compact Administrator of the Commonwealth and of the receiving
state with all information requested by each Compact Administrator, provided
that such information will consist of at least the following;
(a) The name, date and place of birth of the
(b) The identity and
address(es) of the parent(s) and legal guardian(s).
(c) The name and address of the person,
agency or institution to or with which the sending agency proposes to send,
bring or place the child.
full statement of the reasons for such proposed action.
(e) Social assessment of the child and family
(f) Copy of all
court documents relating to custody or adoption of the child, if
(g) A full statement of
what the receiving state is being asked to do regarding the child.
(h) Copy of Request to Place Child (Form
100A), if applicable.
(i) Copy of
Report on Placement Status Change of Child (Form ICPC-100B) for all retroactive
applications, if applicable.
Evidence that surrenders by parent(s) and/or termination of parental rights
were accomplished fully in accordance with the laws of Massachusetts, or
evidence that the process of terminating such rights has been commenced in
accordance with the laws of Massachusetts.
(k) A home study of the proposed placement
site conducted by a placement agency licensed or approved by the receiving
(l) In the case of placement
for purposes of adoption, a description of each expense incurred or to be
incurred by the adoptive parents, the amount of each such expense, the name and
address of the payee, and the date of payment.
(m) In the case of placement for purposes of
adoption, medical background information on the child (if born) and on the
authority of sending agency to place child which may consist of any of the
following as appropriate.
2. Executed Voluntary
3. A notarized
statement by a parent or legal guardian acting as a sending agency;
4. Executed surrender form executed in
accordance with the requirements of M.G.L. c. 210.
(o) Whenever a private child welfare agency
is the sending agency, a copy of its current license.
(p) If a child is of Indian heritage,
verification that the placement is in compliance with the Indian Child Welfare
(q) A pre-placement visitation
plan which is consistent with good social work practice.