Sample CPR - the Leicester City, Leicestershire and Rutland ...

Form CPR
Part D – Siblings (full and half)
Part D – Siblings (full and half) 25
Sibling 1
Surname Brown
First names Jason
Date of birth 21.11.99
Place of birth Leicester
Sex Male
Ethnicity White/British
Nationality British
A recent good quality photograph should be attached if appropriate
Date of photograph:
(This should be written on the back of the photograph.)
Briefly describe the child’s physical characteristics
Jason is a White/British child of slim build with dark brown hair, dark brown
eyes with a pale complexion.
Birth mother’s full name (surname first)
Tina Green
Birth father’s full name (surname first)
Sam Brown
Current carer’s name (where appropriate)
Bethany Jakes
Current carer’s address (where appropriate)
300 Howard Hill, Leicester
Relationship/status of current carer to child
Maternal Grandmother
Is this sibling currently “looked after”?
No
Name and address of the local authority that has responsibility for this
sibling
N/A
Is this child provided with accommodation under section 59(1) of the
Children Act 1989 (accommodated by a voluntary agency)?
No
Legal status of sibling
Residence Order to Bethany Jakes
Is there a court order in force?
Yes
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