New York > Statewide > Family Court > Uniform Interstate Family Support Act
Child Support Enforcement Transmittal 2 Subsequent Actions UIFSA-2 - New York
| Child Support Enforcement Transmittal 2 Subsequent Actions Form. This is a New York form and can be used in Uniform Interstate Family Support Act Family Court Statewide . |
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CHILD SUPPORT ENFORCEMENT TRANSMITTAL #2 - SUBSEQUENT ACTIONS Petitioner Respondent [ ] IV-D Non Public Assistance [ ] IV-D Non PA Medicaid [ ] Full Services [ ] Medical Services Only [ ] 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. [ 3. [ 5. [ 7. [ 8. [ 9. [ ] Status Request 2. [ ] Status Update ] Notice of Hearing 4. [ ] Notice of Case Forwarding ] Document Filed 6. [ ] Order Issued/Confirmed ] Notice of Arrearage Reconciliation/Determination of Sum-Certain ] Change of Payee/Redirection of Payment ] 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 2001 © American LegalNet, Inc. CHILD SUPPORT ENFORCEMENT TRANSMITTAL #2 - SUBSEQUENT ACTIONS Petitioner Respondent [ ] IV-D Non Public Assistance [ ] IV-D Non PA Medicaid [ ] Full Services [ ] Medical Services Only [ ] 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 Return This Page to the Initiating Jurisdiction Page 2 of 2 2001 © American LegalNet, Inc. 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 IVD 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
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