New York Codes, Rules and Regulations › Title 22 - JUDICIARY › Subtitle D - Forms › Chapter IV - Forms of the Family Court of the State of New York and Adoption Forms of the Family Court of the State of New York (cf. s205.7) › Subchapter A - Forms Authorized by Section 205.7 › Uniform Interstate Family Support Act Forms › Form UIFSA-3 - Child support enforcement transmittal #3-request for assistance/discovery

Current through Register Vol. 46, No. 28, July
					 10, 2024
F.C.A. Art. 5-B UIFSA-3
CHILD SUPPORT ENFORCEMENT TRANSMITTAL #3 -
						REQUEST FOR ASSISTANCE/DISCOVERY
Petitioner [Name(Fst, M, Lst) & Social
						Security No.]
[ ] IV-D Non-Public Assistance
[ ] IV-D Non PA Medicaid
[ ] Full Services
[ ] Medical Services Only
Respondent [Name(Fst, M, Lst) Social
						Security No. & address]
[ ] IV-D Public Assistance
[ ] IV-E Foster Care (IV-D Case)
[ ] Non-IV-D
File Stamp
To: (Agency/Tribunal Name and
						Address)
Responding FIPS Code ________ State
						____________
Responding IV-D Case No.
						____________
Responding Docket No. ____________
____________
From: (Contact Person, Agency, Address,
						Phone, Fax, Internet)
Initiating FIPS Code ________ State
						____________
Initiating IV-D Case No.
						____________
Initiating Docket No. ____________
Initiating Jurisdiction [ ] URESA [ ]
						UIFSA State with Continuing Exclusive Jurisdiction (CEJ) ________
Response Needed by ________ (Date)
____________
I. Action
1. [ ] Provide/Obtain Copies of
						Documentation
[ ] Certified Copies of Orders [ ]
						Financial Statement
[ ] Payment Records [ ] Other
						____________
2. [ ] Provide Assistance with Service of
						Process (See Attached)
3. [ ] Provide Assistance with Genetic
						Testing (See Attached)
4. [ ] Obtain Answers for Interrogatories
						(See Attached)
5. [ ] Provide Assistance with
						Teleconference for Hearing or Deposition (See Attached)
6. [ ] Obtain Financial Data/Proof of
						Respondent's Income (See Section II and/or Attached)
7. [ ] Obtain Party Signature on Attached
						Form (See Attached)
8. [ ] Other ____________
Please Return the Acknowledgment Attached
						(2 of 2)
____________
II. Additional Information
()
_____
Date
____________
Initiating Contact Person (Print or
						Type)
__________
Telephone Number & Extension
()
__________
Fax Number
____________
Child Support Enforcement Transmittal #3 -
						Request for Assistance/Discovery OMB No. 0970-0085 Page 1 of 2
CHILD SUPPORT ENFORCEMENT TRANSMITTAL #3 -
						REQUEST FOR ASSISTANCE/DISCOVERY
Petitioner [ ] IV-D Non-Public
						Assistance
[ ] IV-D Non PA Medicaid
[ ] Full Services
[ ] Medical Services Only
Respondent [ ] IV-D Public
						Assistance
[ ] IV-E Foster Care (IV-D Case)
[ ] Non-IV-D
File Stamp
To: (Agency Name and Address)
Responding FIPS Code ________ State
						____________
Responding IV-D Case No.
						____________
Responding Docket No. ____________
____________
From: (Contact Person, Agency, Address,
						Phone, Fax, Internet)
Initiating FIPS Code ________ State
						____________
Initiating IV-D Case No.
						____________
Initiating Docket No. ____________
Initiating Jurisdiction [ ] URESA [ ]
						UIFSA State with Continuing Exclusive Jurisdiction (CEJ) ________
____________
ACKNOWLEDGMENTS To be Completed by
						Responding Agency and Returned to Initiating Agency
[ ] Request Received and No Additional
						Information is Necessary
[ ] Additional Information Needed (See
						Remarks)
[ ] Remarks/Response
[ ] Your Case has been Forwarded for
						Action to:
___________________________
Name of Worker
___________________________
Agency Name
___________________________
Address, FIPS Code
___________________________
Phone & Extension
___________________________
Fax
()
_____
Date
____________
Person Completing Form (Print or
						Type)
__________
Telephone Number & Extension
()
__________
Fax Number
____________
Child Support Enforcement Transmittal
						#3-Request for Assistance/Discovery Return this Page to the Initiating
						Jurisdiction Page 2 of 2
OMB No. 0970 - 0085
INSTRUCTIONS FOR
CHILD SUPPORT ENFORCEMENT
TRANSMITTAL # 3 - REQUEST FOR
						ASSISTANCE/DISCOVERY
PURPOSE OF THE FORM: The CSE Transmittal
						#3-Request for Assistance/Discovery is designed for use when the requesting
						jurisdiction is working its case locally (e.g., by long-arm jurisdiction) and
						needs limited assistance from another jurisdiction, but does not want the other
						jurisdiction to open a IV-d case. Sections 316 and 318 of the model version of
						UIFSA contain specific provisions that allow a tribunal to receive evidence
						from another State and to obtain discovery through a tribunal of another
						State.
When a jurisdiction receives a CSE
						Transmittal #3-Request for Assistance/Discovery from another jurisdiction, it
						should not open a IV-D case; it should only provide the limited assistance
						requested. By contrast, the CSE Transmittal #1-Initial Request is designed for
						use when the initiating State is requesting the responding State to open a IV-D
						case.
Note that under current Federal policy, a
						State is not required to provide assistance requested via a CSE Transmittal #3.
						However, a State may choose to provide such assistance, particularly in the
						interest of avoiding an interstate referral that would require the State to
						work the whole case.
HEADING/CAPTION (Pages 1 & 2): The
						jurisdiction requesting assistance determines the heading. Note that the
						heading appears on both page 1 of the Child Support Enforcement Transmittal #3
						and on page 2, the Acknowledgment page.
Identify the petitioner and respondent in
						the appropriate spaces. Include full name and Social Security Numbers for both
						parties. Include a verified address for the respondent.
Check the appropriate space to identify
						the type of case: IV-D Non Public Assistance; IV-D Non Public Assistance
						Medicaid (indicate whether receiving Full Services or Medical Services Only);
						IV-D Public Assistance; IV-E Foster Care; or Non IV-D. IV-D means the case is
						being worked by the State or local child support enforcement agency (i.e., IV-D
						agency). Public Assistance means the obligee's family receives IV-A cash
						payments [IV-A was formerly called Aid to Families with Dependent Children
						(AAFDC) and is now called Temporary Family Assistance]. A IV-D Non Public
						Assistance Medicaid case is a case where the obligee's family receives Medicaid
						but does not receive Public Assistance (IV-A cash payments).
In the space marked "To:", list the name
						and address (street, city, State, and zip code) of the agency or court where
						you are sending the CSE Transmittal #3.
In the appropriate spaces, if applicable
						and if known, enter the Responding jurisdiction's FIPS code, State, IV-D case
						number, and docket number. Under "docket number", you may enter the docket
						number, cause number, or any other appropriate reference number that the
						responding State may use to identify the case, if known. The "responding"
						jurisdiction is the jurisdiction that receives the request for
						assistance.
In the space marked "From:", list a
						contact person, agency name, address (street, city, State, zip code), phone
						number (including extension), fax number, and Internet address.
In the appropriate spaces, enter the
						Initiating jurisdiction's FIPS code, State, IV-D case number, and docket
						number. Under "docket number", you may enter the docket number, cause number,
						or any other appropriate reference number which the initiating tribunal or
						agency has assigned to the case. The "initiating" jurisdiction is the
						jurisdiction that is requesting assistance.
____________
Instructions for Child Support Enforcement
						Transmittal #3-Request for Assistance/Discovery--Page 1
Check the appropriate box to indicate
						whether the initiating jurisdiction uses the Uniform Reciprocal Enforcement of
						Support Act (URESA) or the Uniform Interstate Family Support Act
						(UIFSA).
In the designated space, note the State
						which you believe has continuing exclusive jurisdiction (CEJ), if known. Under
						UIFSA, a State that issues a child support order maintains CEJ as long as the
						obligor, obligee, or child(ren) reside in that State, or until each party files
						written consent allowing another State to assume CEJ. If there are multiple
						orders governing the same obligor, obligee, and child(ren), UIFSA contains
						rules for determining which order is controlling. The tribunal that issued the
						controlling order has CEJ as long as the conditions for CEJ are met. CEJ means
						the authority to modify the order.
In the space marked "Response Needed by"
						enter the date by which a response is needed.
SECTION I, ACTION: Check the appropriate
						box(es) to indicate which actions are requested. Multiple actions may be
						requested, as appropriate.
Check item 1 "Provide/Obtain Copies of
						Documentation" to request copies of documentation. Check appropriate box(es) to
						indicate the type of documentation: certified copies of orders, payment
						records, financial statement, or other (describe on blank line). In Section II
						"Additional Information", describe your request and provide background
						information necessary to identify the requested documents. If your are
						requesting documents issued by a tribunal, contact the tribunal directly rather
						than the IV-D agency.
Check item 2 "Provide Assistance with
						Service of Process" if you are requesting assistance with service of process.
						You may directly contact (via phone, fax, or other means) the sheriff, or other
						appropriate official, in another jurisdiction to request personal service of
						process. Send the Request for Assistance/Discovery only if such attempts have
						been unsuccessful.
Check item 3 "Provide Assistance with
						Genetic Testing" if you are requesting assistance with genetic testing. Include
						in section II or attach any necessary information or materials, including names
						of genetic testing laboratories, protocols to be followed, testing kits,
						etc.
Check item 4 "Obtain Answers for
						Interrogatories" if you are requesting completion of interrogatories. Attach
						the interrogatories.
Check item 5 "Provide Assistance with
						Teleconference for Hearing or Deposition" if you are requesting assistance in
						scheduling a teleconference for a hearing or deposition. Attach copy of hearing
						notice or deposition.
Check item 6 "Obtain Financial Data/Proof
						of Respondent's Income" if you are requesting financial data or proof of the
						respondent's income. Explain your request in Section II or an
						attachment.
Check item 7 "Obtain Party Signature on
						Attached Form" if you are requesting assistance in obtaining a signature.
						Attach forms which require signatures. Request assistance with obtaining a
						signature only after you have attempted and failed to obtain the signature
						yourself.
____________
Instructions for Child Support Enforcement
						Transmittal #3-Request for Assistance/Discovery--Page 2
Check item 8 "Other" if the reason you are
						requesting assistance or discovery is not listed above. On the blank line,
						indicate the assistance needed; be as specific as possible.
If you are requesting only "quick locate",
						do not use this form. Instead, use the Locate Data Sheet, or CSENet if you are
						using an electronic format.
If you are requesting that the tribunal in
						the other State compel a person over whom it has jurisdiction to respond to a
						discovery order issued by a tribunal of another State (in accordance with
						section 318 of the model version of UIFSA), attach certified copies of the
						discovery order.
SECTION II, ADDITIONAL INFORMATION: In a
						narrative format, indicate any other information that will be useful in
						processing your request. Provide any necessary identifying information and
						background information about why the request is being made, including: (1)
						information on the nature of the pending action (e.g., paternity, support,
						modification, enforcement, etc.) and (2) the reason assistance for the other
						jurisdiction is needed.
At the bottom of page 1, provide a
						specific worker's name, a direct telephone number (with extension if necessary)
						and fax number to expedite communications between jurisdictions.
PAGE 2, ACKNOWLEDGMENT: Upon receiving a
						request for assistance on a CSE Transmittal #3, the receiving State completes
						the Acknowledgments section on page 2. The Acknowledgment can be used to
						provide information in response to a request received via the CSE Transmittal
						#3, or to indicate when (how may days or on what date) the requested
						information/action will be provided. The jurisdiction sending the
						Acknowledgment should indicate where the case has been referred for action, and
						the name, telephone and fax number of a contact person.
**************************************************
The Paperwork Reduction Act of 1995
This information collection is conducted
						in accordance with
						45 CFR
						303.7 of the child support enforcement
						program. Standard forms are designed to provide uniformity and standardization
						for interstate case processing. Public reporting burden for this collection of
						information is estimated to average one hour per response. The responses to
						this collection are mandatory in accordance with
						45 CFR
						303.7. This information is subject to State
						and Federal confidentiality requirements; however, the information will be
						filed with the tribunal and/or agency in the responding State and may,
						depending on State law, be disclosed to other parties. An agency may not
						conduct or sponsor, and a person is not required to respond to, a collection of
						information unless it displays a currently valid OMB control number.
____________
Instructions for Child Support Enforcement
						Transmittal #3-Request for Assistance/Discovery--Page 3