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-7 - Locate data sheet

Current through Register Vol. 46, No. 28, July
					 10, 2024
F.C.A. Art. 5-B UIFSA-7
LOCATE DATA SHEET
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
____________
[ ] Non Custodial Parent Information [ ]
						Custodial Parent Information [ ] Possibly Dangerous
Full Name (First, Mid, Last)
Social Security Number(s)
[ ] Alias [ ] Maiden Name [ ] Mother's Maiden
									 or Father's Name
Current Spouse's Name (Fst, M, Lst)
Date of Birth (or approximate year)
Place of Birth (City, State,
									 County)
Drivers License Number/State
Sex Race Hair Eyes Height Weight Distinguishing
									 Marks, Scars, Tatoos, Glasses, Etc.
____________
Last Known Address - [ ] Residence [ ]
						Mailing [ ] Confirmed
Date ________
Telephone: ()
____________
Usual Occupation/Professional
						Licenses
____________
Last Known Employer (Name, Full Address,
						Federal EIN) [ ] Confirmed
Date ________
Telephone: ()
____________
Other Information, Including Assets,
						Education, Police Record, Public Assistance History
Employment
Wage Qtr ________
Wage Year ________
Attachments: [ ] Photograph [ ] Other
						Items, e.g., Fingerprints Wage Amount ________
____________
()
_______
Date
__________
Initiating Contact Person (Print or
						Type)
__________
Telephone Number and Extension
()
__________
Fax Number
____________
Locate Data Sheet OMB No. 0970 - 0085 Page
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OMB No. 0970 - 0085
INSTRUCTIONS FOR LOCATE DATA SHEET
PURPOSE OF THE FORM: The Locate Data Sheet
						is used for requesting locate information (regarding the parent, employer,
						wages, assets) or services from another State. The requesting jurisdiction
						completes as much of the form as possible with the information it has.
In addition to the more common data
						elements specified on the Locate Data Sheet, space is provided to note other
						locate/asset information particular to the case. For example, information on
						wages, violence potential, military/veteran status, and relatives may prove
						useful in working a case.
In the interest of expediting the locate
						process, use CSENet whenever possible.
Quick Locate. When using the Locate Data
						Sheet to request "quick locate", do not attach the Locate Data Sheet to a Child
						Support Enforcement Transmittal. You may send the request directly to the
						responding State's Parent Locator Service. "Quick locate" is useful if a State
						believes that a noncustodial parent may be in one of several States, but is
						unsure of which State. If a State intends to use its long-arm jurisdiction to
						establish or enforce an order, it may choose to use "quick locate" to confirm
						the noncustodial parent's location.
Using the Locate Data Sheet as Part of an
						Interstate Referral. Attach the Locate Data Sheet to the Child Support
						Enforcement Transmittal #1, and send the request to the responding State's
						central registry. Use of the Child Support Enforcement Transmittal #1 will
						require the responding State to open a IV-D case and provide services. An
						interstate referral should be made in cases where a State is relatively sure
						that the noncustodial parent is in a specific State.
HEADING/CAPTION:
Identify the petitioner and respondent in
						the appropriate spaces.
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
						(AFDC) 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 central registry or
						agency where you are sending the Locate Data Sheet.
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.
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.
____________
Instructions for Locate Data Sheet--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).
BODY OF FORM:
Check the appropriate box to indicate
						whether the locate information pertains to the "Non Custodial Parent" or
						"Custodial Parent". Check the box for "Possibly Dangerous" if the party may be
						dangerous.
Provide as much information about the
						party as possible.
For "Full Name", enter the party's
						complete name (First, Middle, Last).
Provide "Social Security Number" if known;
						this information is vital.
Enter the party's "Alias", "Maiden Name",
						or "Mother's Maiden or Father's Name" if known and check the appropriate box to
						identify the type of name provided.
When listing a party's race, select from
						the following: 1) White (non-hispanic), 2) Black (non-hispanic), 3) Hispanic,
						4) American Indian - Alaskan Native, or 5) Asian - Pacific Islander.
For "Last Known Address" and "Last Known
						Employer" information, indicate if the information has been confirmed/verified
						by the initiating State agency. Indicate the date the information was
						confirmed. If the information has not been confirmed, provide last known
						information.
Under "Employment" in the bottom right
						hand corner, list information obtained from the State Employment Security
						Agency (SESA). Indicate the quarter and year that the information was reported
						to the SESA as well as the wage amount.
At the bottom of the form, provide a
						specific worker's name, a direct telephone number (with extension if necessary)
						and fax number to expedite communication between jurisdictions.
**************************************************
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 Locate Data Sheet--Page
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