Person Management Reference Data. Florida Safe Families Network III. Jr. Sr. U.S. Citizen. Qualified Non-Citizen. Non-Qualified Non-Citizen.
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1 Suffix II III IV Jr. Sr. V VI Citizenship U.S. Citizen Qualified Non-Citizen Non-Qualified Non-Citizen Null Status 212(D)5 Paroled>1Yr Admit Before 8/22/96 212(D)5 Paroled>1Yr Admit On/After8/22/96 Active Duty U.S. Military OR Veteran Amerasian American Indian Born Outside U.S. Battered Indv(204)Qualified Stat. 5 OR > Battered Indv(204)Qualified Status <5YRS Page 1
2 Conditional Entrant Admit Before 8/22/96 Conditional Entrant Admit On Or After 8/22/96 Cuban/Haitian Entrant (501(E)) Deportation Withld (243(H)/241(B)3) Eligible LAOT/HMONG/Spouse/DEP Emergency FS 2005 Granted Asylum (208) LPR Admitted Before 8/22/96 LPR Admitted On Or After 8/22/96 LPR With Prior Amerasian Code LPR With Prior Asylee Code (208) LPR With Prior Cuban/Haitian Entrant LPR With Prior Refugee Code (207) Nat Cuba/HaitiDeport W/HLD243(H)/241(B)3 Nat Cuba/Haiti 212(D)5 Paroled>1 Yr Nat Cuban/Haiti Asylum Applicant Nat Cuban/Haiti Indef Stay Of Deportatio No Qualified/Elig Status (Elig For EMA) Other Ins Stat (Not Elig For EMA) Qual 65 Years Residing On/Before 8/22/96 Qual Child residing On/Before 8/22/96 Qualified Blind/Disabled Qualified Blind/Disabled Or Child < 18 Refugee(207)/Victims Of Human Traffick SDX SUNCAP SDX SUNCAP Ineligible Spouse/Child Of Actv Duty US Miltry/Vetr Victims Of Human Trafficking Page 2
3 SSN Number? Yes Applied For Exempt Ineligible Gender Female Male Type of Birth Verification Birth Certificate Declared Driver s License Estimated Military ID Other ID Passport Page 3
4 Cause of Death Asphyxiation/Suffocation Burns Complications of Prematurity Complications of Prematurity-With Prenatal Drug Exposure Dehydration/Starvation Drowning Drug Overdose Electrocution Failure To Thrive Fire Gunshot Head Trauma/Blunt Force Trauma Hyperthermia Hypothermia Malnutrition Maternal Substance Abuse Medical Medical Condition/Complications Medical Examiner's Report Pending Medical Neglect Multiple Trauma Natural Causes Natural Causes-With Prenatal Drug Exposure Other Poisoning Scalding Page 4
5 Shaken Baby Syndrome SIDS Stabbing Strangulation Substance Abuse Undetermined Vehicular Accident Vehicular Accident-Pedestrian ID Type Birth Certificate CIS/FAHIS Client Number Driver s License Florida PIN ICWSIS Number 1 ICWSIS Number 10 ICWSIS Number 11 ICWSIS Number 12 ICWSIS Number 13 ICWSIS Number 14 ICWSIS Number 15 ICWSIS Number 2 ICWSIS Number 23 ICWSIS Number 3 ICWSIS Number 4 ICWSIS Number 7 Page 5
6 ICWSIS Number 8 ICWSIS Number 9 Medicaid Number Secondary Medicare Number Other Federally Issued ID Other State Issued ID Inactive value: HSN id F_PRSN_T.PRSN_SQ_R Primary Language Albanian American Sign Language Arabic Cambodian Chinese Creole English Farsi Filipino French German Greek Haitian Hmong Hungarian Iranian Italian Page 6
7 Japanese Korean Kosovarian Laotian Latvian Lithuanian Native American Other Other Indo European Polish Portuguese Russian Somali Spanish Spanish/English Bilingual Telecommunications Device for the Deaf Thai Vietnamese Secondary Language Please see the values for Primary Language above. Religion Page 7
8 Amish Anglican Atheist Baptist Buddhist Catholic Eastern Orthodox Episcopal Hindu Jehovah's Witness Jewish Lutheran Mennonite Methodist Mormon Muslim Native American Other None Other Presbyterian Protestant Quaker (Friends) Scientology Seventh Day Adventist Sikh Unaffiliated Unitarian Page 8
9 Marital Status Common Law Marriage Divorced Married Couple Separated Single Female Single Male Unable to Determine Unmarried Couple Widowed Hispanic/Latino Declined No Undetermined Yes Indian Tribe 1 Alaskan Native Apache Blackfeet Cherokee Page 9
10 Chippewa Choctaw Creek Iroquois Nation Miccosukee Other Seminole Sioux Nation Indian Tribe 2 Alaskan Native Apache Blackfeet Cherokee Chippewa Choctaw Creek Iroquois Nation Miccosukee Other Seminole Sioux Nation Additional Page 10
11 Mother s Current Status Deceased Divorced Married Never Married Other Separated Widowed Additional Father s Current Status Deceased Divorced Married Never Married Other Separated Widowed Additional Mother s Marital Status at Time of Child s Birth Deceased Divorced Married Never Married Page 11
12 Separated Unable to Determine Widowed Additional Current Relationship of Parents to Each Other Divorced Married Never Married Paramour Separated Additional Client Characteristics 1 Abuse Abuse and Neglect Alcohol Misuse/ Abuse Behavior Problem Blind/Visually Impaired Chronic Alcoholic Delinquent Behavior Dev. Disability - Mental Retardation Developmental Disability - Other Domestic Violence/Person Responsible Domestic Violence/Victim Page 12
13 Drug Client Drug Misuse / Abuse Emotional Abuse Emotional Disturbance Family Member of Abused/Neglected Child Family Member of Delinquent Family Member of Status Offender Health Impairments Hearing Impaired Medical Neglect Mental Illness Migrant Neglect None Other Handicap Other Special Conditions Physical Abuse Physical Neglect Physically Disabled/Mobility Impaired Refugee Serious and Persistent Mental Illness Severe Emotional Disturbance Severe Health Impairments Sexual Abuse Status Offender Additional Client Characteristics 2 Page 13
14 Abuse Abuse and Neglect Alcohol Misuse/ Abuse Behavior Problem Blind/Visually Impaired Chronic Alcoholic Delinquent Behavior Dev. Disability - Mental Retardation Developmental Disability - Other Domestic Violence/Person Responsible Domestic Violence/Victim Drug Client Drug Misuse / Abuse Emotional Abuse Emotional Disturbance Family Member of Abused/Neglected Child Family Member of Delinquent Family Member of Status Offender Health Impairments Hearing Impaired Medical Neglect Mental Illness Migrant Neglect None Other Handicap Other Special Conditions Physical Abuse Physical Neglect Page 14
15 Physically Disabled/Mobility Impaired Refugee Serious and Persistent Mental Illness Severe Emotional Disturbance Severe Health Impairments Sexual Abuse Status Offender Additional Client Characteristics 3 Abuse Abuse and Neglect Alcohol Misuse/ Abuse Behavior Problem Blind/Visually Impaired Chronic Alcoholic Delinquent Behavior Dev. Disability - Mental Retardation Developmental Disability - Other Domestic Violence/Person Responsible Domestic Violence/Victim Drug Client Drug Misuse / Abuse Emotional Abuse Emotional Disturbance Family Member of Abused/Neglected Child Family Member of Delinquent Family Member of Status Offender Page 15
16 Health Impairments Hearing Impaired Medical Neglect Mental Illness Migrant Neglect None Other Handicap Other Special Conditions Physical Abuse Physical Neglect Physically Disabled/Mobility Impaired Refugee Serious and Persistent Mental Illness Severe Emotional Disturbance Severe Health Impairments Sexual Abuse Status Offender Image Details Page N/A Image Type Person Photo AKA Names Type Also Known As Birth Name Page 16
17 Gang Name Legal Name Maiden Name Married Name Nickname Pre-Merged Name Previously Known As Prior Married Name AFCARS/Other Participant Information Child Was Previously Adopted No Yes Unable to Determine AFCARS/Other Participant Information Age Adopted less than 2 years old 2-5 years old 6 to 12 years old 13 years or older Unable to Determine Page 17
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