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-2 - Child support enforcement transmittal #2-subsequent actions

Current through Register Vol. 46, No. 28, July
					 10, 2024
F.C.A. Art. 5-B UIFSA-2
CHILD SUPPORT ENFORCEMENT TRANSMITTAL #2 -
						SUBSEQUENT ACTIONS
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. ____________
Send Payments To: (if different from
						above)
Payment FIPS Code ________ State
						____________
Bank Account ____________ Routing Code
						________
Initiating Jurisdiction [ ] URESA [ ]
						UIFSA State with Continuing Exclusive Jurisdiction (CEJ) ________
____________
I. Action.
1. [ ] Status Request
3. [ ] Notice of Hearing
5. [ ] Document Filed
2. [ ] Status Update
4. [ ] Notice of Case Forwarding
6. [ ] Order Issued/Confirmed
7. [ ] Notice of Arrearage
						Reconciliation/Determination of Sum-Certain
8. [ ] Change of Payee/Redirection of
						Payment
9. [ ] 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 #2 -
						Subsequent Actions OMB No. 0970 - 0085 Page 1 of 2
CHILD SUPPORT ENFORCEMENT TRANSMITTAL #2 -
						SUBSEQUENT ACTIONS
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. ____________
Send Payments To: (if different from
						above)
Payment FIPS Code ________ State
						____________
Bank Account ____________ Routing Code
						________
Initiating Jurisdiction [ ] URESA [ ]
						UIFSA State with Continuing Exclusive Jurisdiction (CEJ) ________
____________
ACKNOWLEDGMENTS Return This Form to
						Initiating State
[ ] 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 #2 -
						Subsequent Actions Page 2 of 2
OMB No. 0970 - 0085
INSTRUCTIONS FOR
CHILD SUPPORT ENFORCEMENT TRANSMITTAL # 2
						- SUBSEQUENT ACTIONS
PURPOSE OF THE FORM: This transmittal form
						is for use by either the initiating or responding jurisdiction for requesting
						or providing additional information or services in previously-referred cases.
						The CSE Transmittal #2 should not be used for making initial referrals, but
						should only be used for subsequent requests and communication. This form need
						not be sent when the Notice of Controlling Order form is sent. The CSE
						Transmittal #2 should be sent to the local entity working the case (rather than
						the State's central registry) unless the local entity working the case is
						unknown.
HEADING/CAPTION (Pages 1 & 2): The
						jurisdiction which sends the CSE Transmittal #2 determines the heading. Note
						that the heading appears on both page 1 of the Child Support Enforcement
						Transmittal #2 and on page 2 the Acknowledgment page.
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 court or agency where
						you are sending the CSE Transmittal #2. Once an initial referral in a IV-D case
						has been made to the responding State's central registry (using CSE Transmittal
						#1), subsequent communication can occur with the local
						agency/court/jurisdiction that is actually working the case (using CSE
						Transmittal #2).
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 is working the case at the request of the
						initiating jurisdiction.
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 referred the case to the responding jurisdiction for
						services.
In the space marked "Send Payments To:"
						enter the address to which payments should be sent, if the address is different
						from the agency address provided on the form in the space above. Specify the
						case identifier if you want the responding jurisdiction to use an identifier
						other than the initiating IV-D case number when remitting payments.
In the appropriate spaces, enter the FIPS
						code and State where payments should be sent.
____________
Instructions for Child Support Enforcement
						Transmittal #2 - Subsequent Actions Page 1
If funds can be transmitted electronically
						via Electronic Funds Transfer (EFT), enter the bank account number under "Bank
						Account" and the bank routing code under "Routing Code".
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 appropriate space, enter 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.
SECTION I (page 1), ACTION: Check the
						appropriate box(es) to indicate which actions are requested or what information
						is being provided. Multiple boxes may be checked, as appropriate.
Check item 1 "Status Request" if you are
						asking for a status update. Describe the request in Section II.
Check item 2 "Status Update" if you are
						providing a status update. Provide the update in Section II.
Check item 3 "Notice of Hearing" if you
						are providing notice of an upcoming hearing. Provide dates and other
						information in Section II.
Check item 4 "Notice of Case Forwarding"
						if you are providing notice that you have forwarded a misdirected case to the
						appropriate jurisdiction. Explain in Section II.
Check item 5 "Document Filed" if you are
						providing notice that document has been filed. Explain in Section II.
Check item 6 "Order Issued/Confirmed" if
						you are providing notice that an order has been issued or confirmed. Attach a
						copy of the order.
Check item 7 "Notice of Arrearage
						Reconciliation/Determination of Sum-Certain" if you are providing notice of an
						arrearage reconciliation or determination of sum-certain. Attach any
						calculations or worksheets used.
Check item 8 "Change of Payee/Redirection
						of Payment" to request a change of payee or redirection of payment. Describe
						your request in Section II "Additional Information". "Change of Payee" is an
						administrative action used when the person or agency entitled to receive funds
						has changed. It may occur with a change in Public Assistance or Foster Care
						status or a change in custody. "Redirection of Payment" is an administrative
						action used when the custodian has moved. In some States a court action may be
						required if the custodian's move compels transfer of documents or funds to
						another jurisdiction.
Check item 9 "Other" if you are requesting
						a service or providing information other than the types listed. Describe the
						service or information on the blank lines.
Check the box beside "Please return the
						Acknowledgment Attached" if an acknowledgment is needed.
____________
Instructions for Child Support Enforcement
						Transmittal #2 - Subsequent Actions Page 2
SECTION II (page 1), ADDITIONAL
						INFORMATION: In this section, provide additional information which may be
						useful.
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: When a
						jurisdiction sends a CSE Transmittal #2 to another jurisdiction, it should
						include Page 2 Acknowledgment only if the jurisdiction is requesting
						information or action. If the jurisdiction is sending the Transmittal #2 to
						provide notice or information, Page 2 Acknowledgment is not needed.
Upon receiving a request for action or
						information on a CSE Transmittal #2, the receiving State completes the
						Acknowledgments section of page 2. The Acknowledgment can be used to provide
						any information requested on the CSE Transmittal #2, or to indicate when (how
						many days or on what date) the requested information will be provided. The
						jurisdiction sending the Acknowledgment must 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 #2 - Subsequent Actions Page 3