Registration Statement Form. This is a New York form and can be use in Family Court Statewide.
Tags: Registration Statement, UIFSA-9, New York Statewide, Family Court
LETTER OF TRANSMITTAL REQUESTING REGISTRATION002 THIS FORM CONTAINS SENSITIVE INFORMATION 226 DO NOT FILE THIS FORM IN A PUBLIC ACCESS FILE. The information on this form may be Initiating IV-D Case Identifier: Responding Tribunal Number: Initiating Tribunal Number: NOTE: Action: [ ] Register for Enforcement [ ] Nondisclosure Finding/Affidavit attached [ ] Register for Enforcement of Arrears Only [ ] This form sent through EDE [ ] Assigned Arrears [ ] Non-assigned Arrears [ ] Register for Modification [ ] Register for Modification and Enforcement Section I. Case Summary: (Background of this matter: court / administrative actions)Date of support order: State and county/tribe issuing order: Tribunal number: Current Obligation Amount Current medical s upport $ Current spousal s upport $ Other: $ Type of Arrears Amount Total child support arrears $ Total medical support arrears $ Total spousal support arrears $ Total interest $ Other: $ Total amount of a rrears: (Attach documentation of TANF time periods.) Section II. Obligee Information: [ ] Parent [ ] Caretaker Obligee222s legal name (first, middle, last, suffix): 002 Obligee222s address: 002 If caretaker, relationship to child(ren): [ ] Has legal custody/guardianship of the child(ren)002 Section III. Obligor Information: Obligor222s legal name (first, middle, last, suffix): Obligor222s address: SSN: Employer Name: Employer address: Letter of Transmittal Requesting Registration OMB 0970 226 0085 Expiration Date: Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com LETTER OF TRANSMITTAL REQUESTING REGISTRATION , PAGE 2002 Section IV. Other Pertinent Information: This order is registered in the following states: 002 Attach description and location of any property not exempt from execution.002 Identify any source of income of the obligor in addition to employment: 002 Other: 002 Section V. Attachments: Required 226 Two copies, including one certified copy, of the order to be registered,002 including any modification of the order.002 The following documents are also attached and part of this Letter of Transmittal Requesting Registration: [ ] Certified statement of arrears (IV-D agency or other government entity record) [ ] Sworn statement of arrears (direct payments) [ ] Order determining arrears [ ] Description and location of any property not exempt from execution [ ] Other attachments: NOTE: If requesting registration for modification, also attach a Uniform Support Petition, General Testimony, and a Personal002 Information Form for UIFSA 247 311.002 Section VI. Declaration: Under penalty of perjury, all information and facts stated in this Letter of Transmittal Requesting Registration are true to the best of my knowledge and belief. Date Name [ ] Party seeking registration [ ] IV-D representative/title Signature Date Printed name of petitioner222s private attorney and Signature of petitioner222s private attorney attorney/bar number (if applicable) Encryption Requirements: When communicating this form through electronic transmission, precautions must be taken to ensure the security of the data. Child support agencies are encouraged to use the electronic applications provided by the federal Office of Child Support Enforcement. Other electronic means, such as encrypted attachments to e-mails may be used if the encryption method is compliant with Federal Information Processing Standard (FIPS) Publication 140-2 (FIPS PUB 140-2). Instructions for Registration Statement Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTIONS FOR LETTER OF TRANSMITTAL REQUESTING REGISTRATION PURPOSE OF THE FORM: The Letter of Transmittal Requesting Registration is completed by the initiating jurisdiction to request registration of an existing order for enforcement and/or modification in the responding jurisdiction. The purpose of the form is to provide specific order information to the responding jurisdiction. This form can be used in IV-D and non-IV-D intergovernmental cases. It should be included with the other appropriate forms and, in IV-D cases, directed to the responding jurisdiction222s central registry. THIS FORM CONTAINS SENSITIVE INFORMATION 226 DO NOT FILE THIS FORM IN A PUBLIC ACCESS FILE. This form includes information that may pose a significant risk to an individual if made available in a public forum or inappropriately disclosed. This form can be filed with the tribunal, but should not be filed or included in a record available to the general public. The information on this form may be disclosed to the parties in the case, unless accompanied by a nondisclosure finding/affidavit. If you are not the intended recipient, you are hereby notified that any use, disclosure, distribution, or copying of this form or its contents is strictly prohibited. If this is a IV-D case, the Transmittal #1 and the Child Support Agency Confidential Information Form must be attached. HEADING/CAPTION: In the appropriate spaces, if applicable and if known, enter the responding jurisdiction222s IV-D case identifier and tribunal number. In the appropriate spaces, enter the Initiating jurisdiction222s IV-D case identifier, and, if applicable, tribunal number. Italicized text that appears within a 223box224 refers to policy or provides additional information. The responding jurisdiction is the jurisdiction that is working the case at the request of the initiating jurisdiction. Under 223IV-D case identifier,224 enter the number/identifier identical to the one submitted on the Federal Case Registry, which is a left-justified up to 15-character alphanumeric field, allowing all characters except asterisk and backslash, and with all characters in uppercase. Under 223tribunal number,224 you may enter the docket number, cause number, or any other appropriate reference number that the responding tribunal may use to identify the case, if known. The initiating jurisdiction is the jurisdiction that referred the case to the responding jurisdiction for services. Under 223IV-D case identifier,224 enter the number/identifier identical to the one submitted on the Federal Case Registry, which is a left-justified up to 15-character alphanumeric field, allowing all characters except asterisk and backslash, and with all characters in uppercase. Under 223tribunal number,224 you may enter the docket number, cause number, or any other appropriate reference number that the initiating tribunal has assigned to the case. For an address outside the United States, be sure to include the foreign country and postal code. Tribal IV-D programs may choose to use the federal Intergovernmental forms. However, they are not required to use or accept such forms. If you have any questions, contact the tribal IV-D agency directly using the contact information on the OCSE website. Where forms request a locator code, note that tribal locator codes uniquely identify tribal cases with 2239224 in the first position, 0 (zero) in the second position, and then a 3-character tribal code defined by the Bureau of Indian Affairs (BIA). Letter of Transmittal Requesting Registration Instructions Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com This form sent through EDE -Check if this form was sent through the Electronic Document Exchange (EDE). The following options are available for making IV-D requests and sending information on IV-D cases: 1. CSENet transactions are the recommended method for making requests or sending information to another state. If CSENet is not listed as an option on the form, then it cannot be used to convey any of the requests for information or IV-D requests provided on the form. Supporting documentation should be sent through EDE, whenever possible. If certified copies are needed, hard copies should also be sent by mail. Mail or fax may also be used for all documents when EDE is not available. 2. If CSENet transactions are not available in your state, EDE is the next preferred method for transmitting your request or information. Both your state and the receiving state must be using the EDE application to use this communication method. 3. If the EDE application is not available in your state or the receiving state, then mail o