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Distribution of Federally Approved Interstate Forms: Administrative Subpoena and Notice of Lien

AT-97-19

Published: November 20, 1997
Information About:
State/Local Child Support Agencies
Topics:
Case Management, Enforcement, Intergovernmental/Interstate
Types:
Policy, Action Transmittals (AT)
Tags:
Administrative/Judicial Processes, Lien and Levy

Note: We have tried to make this Internet document appear as much like the original document as possible, but since it is basically a set of forms, it may not look exactly the same.

ACTION TRANSMITTAL
OCSE-AT-97-19
November 20,1997

TO: STATE AGENCIES ADMINISTERING CHILD SUPPORT ENFORCEMENT PLANS UNDER TITLE IV-D OF THE SOCIAL SECURITY ACT AND OTHER INTERESTED INDIVIDUALS

SUBJECT: Distribution of Federally Approved Interstate Child Support Enforcement Forms: Administrative Subpoena and Notice of Lien.

ENCLOSED: Attached are copies of the Administrative Subpoena form and instructions and the Notice of Lien form and instructions.

STATUTORY REFERENCE: 42 U.S.C. 642(a)(11) and 42 U.S.C. 654(9)(E), as amended by section 324 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, PL 104-193.

BACKGROUND: Section 324 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, PL 104-193, amends sections 442 and 454 of Title IV, Part D, of the Federal Social Security Act to require the Federal Office of Child Support Enforcement (OCSE) to promulgate administrative subpoena and lien forms for use in interstate child support enforcement. On March 3, 1997, the Federal Office of Management and Budget (OMB) approved the administrative subpoena and lien forms pursuant to emergency clearance procedures under 5 C.F.R. 1320.13. Effective October 28, 1997, both forms received final approval.

SUPERSEDED MATERIAL: As a result of OMB's final approval, the current versions of these two forms supersede the previous versions that were distributed to the States on March 6, 1997 (OCSE-AT-97-03).

ACTION REQUIRED: The attached versions of the Administrative Subpoena and Notice of Lien are to be implemented upon receipt.

INQUIRIES: Steve Cesar, Federal OCSE, 202-401-5436;
ACF Regional Administrators

______________________________________
David Gray Ross/s/
Deputy Director
Office of Child Support
Enforcement

OMB Control #: 0970-0152

Expiration Date: 10-31-00

Administrative Subpoena

TO:

REGARDING:

Case Caption:

FROM:

Issuing State Case Number:

The undersigned COMMANDS you to provide financial or other information needed to establish, modify, or enforce a support order, under the authority of Federal law (42 U.S.C. 666(c)(1)), the law of the issuing state (_____________________________), and similar statutes in all other states.

Provide the following information or documents:


to the agent issuing this subpoena by this date:

 

The information or documents may be mailed or sent by facsimile transmission. Your response to this subpoena must be dated, signed by you or your designee, and be [ ] notarized - [ ] witnessed with the following statement:



"I declare (or certify, verify, or state) under penalty of perjury that the foregoing is true and correct. Executed on (date)."


The undersigned states that, as an authorized agent of a state or county agency responsible for implementing the child support enforcement program set forth in Title IV, Part D, of the Federal Social Security Act (42 U.S.C. 651, et seq.), I have legal authority to issue this subpoena to have effect in any state. Failure to obey this subpoena may result in the imposition of penalties, including fines or imprisonment, as provided under the laws of your state. For additional information regarding this subpoena, including how to challenge it, please contact the issuing agency (see the "FROM" field, above) and reference the issuing state case number.


Date ____________________

Authorized Agent ________________________


Notice: Respondents are not required to respond to this information collection unless it displays a valid OMB control number. The average burden for responding to this information collection is estimated at 30 minutes. If you believe this estimate is inaccurate, or if you have ideas to reduce this burden, please provide comment to the issuing agency.

OMB Control #: 0970-0152

Expiration Date: 10-31-00

Administrative Subpoena

TO: 1

REGARDING: 2

Case Caption: 3

FROM: 4

Issuing State Case Number: 5

The undersigned COMMANDS you to provide financial or other information needed to establish, modify, or enforce a support order, under the authority of Federal law (42 U.S.C. 666(c)(1)), the law of the issuing state ( _________________________ 6 ), and similar statutes in all other states.

Provide the following information or documents: 7


to the agent issuing this subpoena by this date: 8


The information or documents may be mailed or sent by facsimile transmission. Your response to this subpoena must be dated, signed by you or your designee, and be [ 9 ] notarized - [ 10 ] witnessed with the following statement:


"I declare (or certify, verify, or state) under penalty of perjury that the foregoing is true and correct. Executed on (date)."


The undersigned states that, as an authorized agent of a state or county agency responsible for implementing the child support enforcement program set forth in Title IV, Part D, of the Federal Social Security Act (42 U.S.C. 651, et seq.), I have legal authority to issue this subpoena to have effect in any state. Failure to obey this subpoena may result in the imposition of penalties, including fines or imprisonment, as provided under the laws of your state. For additional information regarding this subpoena, including how to challenge it, please contact the issuing agency (see the "FROM" field, above) and reference the issuing state case number.

Date 11_____________

Authorized Agent 12 ______________________________________


Notice: Respondents are not required to respond to this information collection unless it displays a valid OMB control number. The average burden for responding to this information collection is estimated at 30 minutes. If you believe this estimate is inaccurate, or if you have ideas to reduce this burden, please provide comment to the issuing agency.



Instructions for the Administrative Subpoena
 

Purpose of this form: The Administrative Subpoena (subpoena) is the Federal form that the State IV-D programs, pursuant to section 454(9)(E) of the Social Security Act, are required to use in interstate cases. A State may elect to use this form in intrastate cases. This form is to be administratively issued by the IV-D program to subpoena financial or other information needed to establish, modify, or enforce a support order.

To complete this form:

1. Place, in the "TO" field, the name and address of the individual or entity on whom you are serving the subpoena. (Frequently, this will be an employer.)

2. Place, in the "REGARDING" field, the name, dob, and SSN (if available) of the individual you are requesting information about. (Frequently, this will be the noncustodial parent.)

3. Place, in the "Case Caption" field, the title of the proceeding (i.e., John Doe v. Jane Doe), under which you are issuing the subpoena.

4. Place, in the "FROM" field, the name of the IV-D office issuing the subpoena, including its address/phone/fax numbers.

5. Provide the IV-D case number, or other case identifier, in the space following "Issuing State Case Number".

6. Insert the citation for your State statute that allows you to issue an administrative subpoena.

7. Clearly, completely, and specifically describe all records or documents that you are requesting the individual receiving the subpoena provide.

8. Provide the date that the requested documents are to be provided to you.

9. Check the "notarized" box if you require notarized documents.

10. Check the "witnessed" box if you do not require notarized documents.

11. Place the date the subpoena is signed in the "date" field.

12. Have the person issuing the subpoena sign in the "signature" field.


OMB Control #: 0970-0153

 

Notice of Lien

TO:

Obligor:

(Name/dob/ssn)

FROM:

(Claimant)

Obligee:

(Name)


Claimant's Case #:


This lien results from a child support order, entered on by in docket number . This order requires the above-named obligor to pay child support in the amount of $ ________per __________ _________.

As of _____________, the obligor owes unpaid support in the amount of $ , and this lien amount is subject to an interest rate of ________________.

Prospective amounts of child support, not paid when due, are judgments and accrue to the lien amount. This lien attaches to all non-exempt real and personal property of the above-named obligor, which is located or recorded within the state/county/other subdivision of the state of filing, including any property specifically described below.


Specific description of property:

 

The priority and enforcement aspects of this lien are governed by the law of the state where the property is located. An obligor must follow the laws and procedures of the state where the property is located or recorded to contest or challenge this lien. This lien remains in effect until released by the claimant or in accordance with the laws of the state of filing.


The box to be used by the Lein Recorder that appears here in the printed copy is not included in the Internet version of this document.

 

Note to Lien Recorder: Please provide the claimant with a copy of the filed lien, containing the recording information, at the address provided above.

Check either "A" or "B":


A [ ] Issued by a IV-D agency/office

As an authorized agent of a state, or subdivision of a state, responsible for implementing the child support enforcement program set forth in Title IV, Part D, of the Federal Social Security Act (42 U.S.C. 651 et seq.), I have authority to file this child support lien in any state, or U.S. Territory. For additional information regarding this lien, including the pay-off amount, please contact the authorized agency (claimant) at the address provided above. Please reference the case number, also provided above.


Date ___________

Authorized Agent_______________________________


B [ ] Issued by a private (non-IV-D) attorney


I am an attorney representing the above-named obligee. I certify that this lien is issued in accordance with the laws of the state of ___________________________.

For additional information regarding this lien, including the pay-off amount, please contact the undersigned (claimant) at the address provided above.

Date ___________________

Attorney for Obligee____________________________



************************************


State of: ____________________

County of: ____________________


I certify that __________________________________ appeared before me and is known to me as the individual who signed the above.

Date: ________

________________________ Notary Public



My appointment expires __________________________________


Notice: Respondents are not required to respond to this information collection unless it displays a valid OMB control number. The average burden for responding to this information collection is estimated at 30 minutes. If you believe this estimate is inaccurate, or if you have ideas to reduce this burden, please provide comment to the issuing agency.

OMB Control #: 0970-0153

Notice of Lien

TO: 1

Obligor: 2

(Name/dob/ssn)

FROM: 3

(Claimant)

Obligee: 4

(Name)


Claimant's Case #: 5


This lien results from a child support order, entered on __________ 6_______ by 7_________ in 8 docket number_________ 9 . This order requires the above-named obligor to pay child support in the amount of $_______ 10_____ per ________ 11 .

As of 12 ____________________________, the obligor owes unpaid support in the amount of $_________13 , and this lien amount is subject to an interest rate of__________ 14 .

Prospective amounts of child support, not paid when due, are judgments and accrue to the lien amount. This lien attaches to all non-exempt real and personal property of the above-named obligor, which is located or recorded within the state/county/other subdivision of the state of filing, including any property specifically described below.

 

Specific description of property: 15


The priority and enforcement aspects of this lien are governed by the law of the state where the property is located. An obligor must follow the laws and procedures of the state where the property is located or recorded to contest or challenge this lien. This lien remains in effect until released by the claimant or in accordance with the laws of the state of filing.


The box to be used by the Lein Recorder that appears here in the printed copy is not included in the Internet version of this document.

Note to Lien Recorder: Please provide the claimant with a copy of the filed lien, containing the recording information, at the address provided above.

Check either "A" or "B":

A [16] Issued by a IV-D agency/office


As an authorized agent of a state, or subdivision of a state, responsible for implementing the child support enforcement program set forth in Title IV, Part D, of the Federal Social Security Act (42 U.S.C. 651 et seq.), I have authority to file this child support lien in any state, or U.S. Territory. For additional information regarding this lien, including the pay-off amount, please contact the authorized agency (claimant) at the address provided above. Please reference the case number, also provided above.




17Date _________ Authorized Agent_______________18



B [19] Issued by a private (non-IV-D) attorney

I am an attorney representing the above-named obligee. I certify that this lien is issued in accordance with the laws of the state of __________________________________

For additional information regarding this lien, including the pay-off amount, please contact the undersigned (claimant) at the address provided above.

Date ___________20 Attorney for Obligee __________________________21
 

************************************

State of _____________________________

County of _____________________________


I certify that __________________________________ appeared before me and is known to me as the individual who signed the above.


Date:_____________________

Notary Public_________________________


My appointment expires _______________________________

Notice: Respondents are not required to respond to this information collection unless it displays a valid OMB control number. The average burden for responding to this information collection is estimated at 30 minutes. If you believe this estimate is inaccurate, or if you have ideas to reduce this burden, please provide comment to the issuing agency.

Instructions for the Notice of Lien
 

Purpose of this form: The Notice of Lien (lien) is the instrument to use to impose liens in interstate child support cases. 42 USC 654(9)(E) requires all IV-D programs to use this form. This form may also be used in non-IV-D cases by private attorneys.

Whose laws apply?: The lien must be issued in accordance with state law. Issue the lien to secure debts for past-due support upon identifying, in another state, nonexempt real or personal property belonging to the obligor. The laws and procedures of the state where the property is located or recorded determine which office or entity in that state is the appropriate one to receive the lien for filing. It is the responsibility of the agency/office or private attorney issuing the lien to file it with the appropriate entity.

Enforcement and Release: If enforcement of the lien is desired in a IV-D case, the agency/office issuing the lien should request such enforcement action from the IV-D agency in the state where the property is located. To release a previously-filed lien (e.g., upon receipt of full payment, or partial payment with an acceptable agreement to repay remaining balance, etc.,) the original issuing state or, if appropriate, the state taking enforcement action, shall use their existing local release of lien form. The release of lien should be provided to the obligor, the office or entity which filed the lien and, if appropriate, all interested IV-D agencies/offices. Identify the lien to be released by including the recording information provided by the office or entity which filed the lien (Lien Recorder). The laws and procedures of the state where the lien is filed control the release of the lien.

To complete this form:

1. In the "TO" field: insert the name and address of the office or entity (i.e., County Auditor, Clerk of Court, DMV, etc.) to which you are sending the lien.

2. In the "OBLIGOR" field: insert the obligor's full name, DOB, and SSN (if known). Include known aliases or multiple SSNs used by the obligor.

3. In the "FROM (Claimant)" field: insert the name, address and phone/fax numbers of the office that is issuing this lien.

4. In the "OBLIGEE" field: insert the obligee's full name.

5. In the "Claimant's Case #" field: insert the IV-D or other appropriate case number.

6. In the space following "entered on": insert the date of entry of the order which is the basis for the lien.

7. In the space following "by": identify the name of the tribunal (court or administrative) that issued the support order which is being used to determine the amount of the lien.

8. In the space following "in": identify the location (state/county) of the tribunal that issued the support order that is being used to determine the amount of the lien.

9. In the space following "docket number": identify the tribunal docket, jacket or file number of the support order that is used to determine the amount of the lien.

10. In the space following "in the amount of $": insert the amount of the current/prospective support obligation.

11. In the space following "per": identify the frequency (month/week, etc.) with which the current support is ordered to be paid.

12. In the space following "As of": insert the date of the debt calculation that is used in determining the amount of the lien.

13. In the space following "amount of $": insert the lien amount (the amount of the past-due support obligation owed, including any accrued interest, when the lien is prepared) .

14. In the space following "interest rate of": insert the interest rate that is being charged to the debt. If interest is not being charged insert "n/a".

15. If applicable, in the space following "Specific description of property", identify any specific property that you want the lien to attach to. Use the legal description of real property and, when the target of the lien is personal property, always provide the most specific identifying information available, including the location of the property, if known. (For example, include the make/model/year/appropriate registration numbers (if known), as opposed to referring to such personal property as"farm equipment".)

Two options are provided for the signature of the individual issuing the lien.

16. If the lien is being issued by a IV-D agency/office, check the box following "A" near the top of page 2.

17. Provide the date the lien is signed on the line provided above "date".

18. The appropriate individual in the IV-D agency/office signs the lien on the line above "Authorized Agent". Type or print the name of the agent signing the lien below their signature.

19 If the lien is being issued by a private attorney in an non-IV-D case, check the box following "B".

20. If the lien is being issued by a private attorney in a non-IV-D case, check the box following "B" near the top of page 2.

21. Provide the date the lien is signed on the line provided above "date".

The signature of the individual (IV-D agent, or private attorney) signing the lien must be notarized.

Send a copy of the lien to the obligor at his/her last known address.

###