Family & Protective Services Letterhead - DOC by 6Ru726Y

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									                       TEXAS DEPARTMENT OF FAMILY AND PROTECTIVE SERVICES


COMMISSIONER
Anne Heiligenstein

                                    SAMPLE MEMBERSHIP QUERY
                          [Send by FAX & registered mail, return receipt requested]

DATE


Name of Tribe
Address of Tribe

         Re:         URGENT Membership Inquiry

Dear Tribal Leaders of the [Name of Tribe],

The Texas Department of Family and Protective Services has information that the child named
below may be an Indian child within the meaning of the Indian Child Welfare Act, 25 U.S.C. §1901
et seq. In the course of an investigation [Describe source and type of information regarding tribal
connection reported if possible, i.e. paternal grandfather reported that his mother was a Cherokee].

We enclose a Child & Family Questionnaire with available information about the child’s family
history. To serve the best interests of this child and promote the goals of the Indian Child Welfare
Act, we ask for the Tribe’s confirmation as to whether this child is a member of the tribe, or either
parent is a member and the child is eligible for membership.

To avoid any delay in developing a permanent plan for this child, we request response within
fifteen (15) days to confirm or deny the status of this child if possible. Please advise if additional
time is required.

Your assistance is greatly appreciated. If you have any questions about this matter, please contact
either myself or my supervisor.

Caseworker Name:                                          Supervisor Name:
Title:                                                    Title:
Phone:                                                    Phone:
Fax Number:                                               Fax Number:

Thank you,



Caseworker Name
Contact information




                 701 W. 51ST ST.  P.O. BOX 149030  AUSTIN, TEXAS 78714-9030  (512) 438-4800

								
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