Provision of Services in Interstate Child Support Enforcement: Standard Forms

Forms and Documents

Document Name	Status
Form 1 Uniform Support Petition Form and Instruction	Modified
Form 1 Affidavit / Paternity Form and Instruction	Modified
Form 1 General Testimony Form and Instruction	Modified
Form 1 Locate Data Sheet Form and Instruction	Modified
Form 1 Contolling Order Form and Instruction	Modified
Form 1 Registration Statement Form and Instruction	Modified
Form 1 Transmittal 1 Form and Instruction	Modified
Form 1 Transmittal 2 Form and Instruction	Modified
Form 1 Request for Assistance/Discovery Form and Instruction	Modified
OMB-0970-0085-GI_General_Testimony_Instructions.pdf Supplementary Document	2010-12-30
2011 supstat 0970-0085 05052011.doc Supporting Statement A	2011-05-09

IC Document Collections

IC ID	Document Title	Status
9837	Uniform Support Petition Form and Instruction	Modified
182930	Affidavit / Paternity Form and Instruction	Modified
182929	General Testimony Form and Instruction	Modified
182928	Locate Data Sheet Form and Instruction	Modified
182927	Contolling Order Form and Instruction	Modified
182926	Registration Statement Form and Instruction	Modified
182925	Transmittal 1 Form and Instruction	Modified
182924	Transmittal 2 Form and Instruction	Modified
182923	Request for Assistance/Discovery Form and Instruction	Modified

ICR Details

OMB Control No: 0970-0085	ICR Reference No: 201101-0970-002
Status: Historical Active	Previous ICR Reference No: 200712-0970-001
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Provision of Services in Interstate Child Support Enforcement: Standard Forms
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 05/25/2011
	Date Received in OIRA: 01/31/2011
Terms of Clearance: As per previous terms of clearance for this ICR, ACF must display the expiration date on this collection. Because the information is transferred electronically between states and because there were no comments received from States which indicate the States have trouble interpreting what the expiration date means and does not mean, the request for exemption does not appear to be substantiated.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2014	36 Months From Approved	05/31/2011
Responses	3,819,906	0	3,819,906
Time Burden (Hours)	662,138	0	662,138
Cost Burden (Dollars)	0	0	0

---

Abstract: Section 311(b) of the Uniform Interstate Family Support Act (UIFSA) requires states to use standard interstate forms as mandated by federal law. 45 CFR 303.7 also requires IV-D agencies to transmit child support case information on standard interstate forms when referring cases to other states for processing. This ICR seeks approval for revisions to the approved forms.

---

Authorizing Statute(s): US Code: 45 USC 303.7(b)(3) Name of Law: 666(f)
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 13291	03/19/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 82406	12/30/2010
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 9

IC Title	Form No.	Form Name
Uniform Support Petition	1	Uniform Petition
Request for Assistance/Discovery	1	Tranmittal 3
Transmittal 2	1	Tranmittal 2
General Testimony	1	General Testimony
Affidavit / Paternity	1	General Testimony - instructions
Transmittal 1	1	Transmittal 1
Registration Statement	1	Registration Statement
Contolling Order	1	Controlling Order
Locate Data Sheet	1	Locate Data Sheet

---

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	3,819,906	3,819,906	0	0	0	0
Annual Time Burden (Hours)	662,138	662,138	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/31/2011

---