New York > Statewide > Family Court > Uniform Interstate Family Support Act
Child Support Enforcement Transmittal 3 Request For Assistance Or Discovery UIFSA-3 - New York
| Child Support Enforcement Transmittal 3 Request For Assistance Or Discovery 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 #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 Respondent [Name (Fst, M, Lst), Social Security No. & Address] [ [ [ [ To: (Agency/Tribunal Name and Address) ] Medical Services Only ] IV-D Public Assistance ] IV-E Foster Care (IV-D Case) ] Non-IV-D File Stamp 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 [ ] 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: ___________________________________________________________________________ 1. Please Return the Acknowledgment Attached II. Additional Information (2 of 2) ___________________ 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 2001 © American LegalNet, Inc. CHILD SUPPORT ENFORCEMENT TRANSMITTAL #3 - REQUEST FOR ASSISTANCE/DISCOVERY 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. ___________________________________________________ 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 2001 © American LegalNet, Inc. OMB No. 0970 - 0085 INSTRUCTIONS FOR CHILD SUPPORT 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/discovery 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 (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 agency or court where you are sending the CSE Transmittal #3. In the appropriate spaces, if applicable and if known, enter the R
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