Form 1 Tranmittal 2

CHILD SUPPORT ENFORCEMENT TRANSMITTAL #2 – SUBSEQUENT ACTIONS
Petitioner: Name (first, middle, last)
Social Security Number
Tribal Affiliation/Country (if applicable)

IV-D Case:

Respondent: Name (first, middle, last)

Non-IV-D Case:

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[
[
[
[

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TANF
IV-E Foster Care
Medicaid Only
Former Assistance
Never Assistance

[ ]
File Stamp

Social Security Number
Tribal Affiliation/Country (if applicable)
Responding FIPS Code
To: (Agency Name and Address)

State

Responding IV-D Case Identifier
Responding Tribunal Number

From: (Contact Person, Agency, Address, Phone, FAX, E-mail)
Initiating FIPS Code

State

Initiating IV-D Case Identifier
Initiating Tribunal Number
Send Payments To: (if different from above)

Payment FIPS Code

State

Bank Account

Routing Code

I. Action

1. [ ] Status Request

7. [ ] Notice of Arrearage Reconciliation/Determination of Sum-Certain

2. [ ] Status Update

8. [ ] Change IV-D Payee of Responding Tribunal Order

3. [ ] Notice of Hearing

9. [ ] Redirect Payment to Obligee State

4. [ ] Notice of Case Forwarding

10. [ ] Other:

5. [ ] Document Filed
6. [ ] Order Issued/Confirmed

Please Return the Acknowledgment Attached
II. Additional Information
[ ] Nondisclosure Finding Attached

(
Date

FAX:

(

Initiating Contact Person (first, middle, last)

)

Child Support Enforcement Transmittal #2 – Subsequent Actions

)
Phone Number & Extension

E-mail

OMB 0970 – 0085 Expiration Date: 01/31/2014

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CHILD SUPPORT ENFORCEMENT TRANSMITTAL #2 – SUBSEQUENT ACTIONS
Petitioner: Name (first, middle, last)
Social Security Number
Tribal Affiliation/Country (if applicable)

Respondent: Name (first, middle, last)

IV-D Case:

Non-IV-D Case:

[
[
[
[
[

]
]
]
]
]

TANF
IV-E Foster Care
Medicaid Only
Former Assistance
Never Assistance

[ ]
File Stamp

Social Security Number
Tribal Affiliation/Country (if applicable)
Responding FIPS Code
To: (Agency Name and Address)

State

Responding IV-D Case Identifier
Responding Tribunal Number

From: (Contact Person, Agency, Address, Phone, FAX, E-mail)
Initiating FIPS Code

State

Initiating IV-D Case Identifier
Send Payments To: (if different from above)

Initiating Tribunal Number

ACKNOWLEDGMENTS

Payment FIPS Code

State

Bank Account

Routing Code

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 (first, middle, last)
Agency Name
Address, FIPS code

Phone, Extension & FAX

(
Date
FAX: (

)

Person Completing Form (first, middle, last)

)
Telephone Number & Extension

E-mail

Child Support Enforcement Transmittal #2 – Subsequent Actions

Return This Page to the Initiating Jurisdiction

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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. Transmittal #2 may be sent
electronically using the appropriate CSENet transaction .

Italicized text that appears within a “box” refers to policy or provides additional information.
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 by name (first, middle, last), Social Security Number, and, if applicable,

include the name of the tribe or country in which the petitioner or respondent is associated.
• Check the appropriate space to identify the type of case: TANF; IV-E Foster Care, Medicaid only; former assistance,

never assistance, or Non-IV-D.
TANF means the obligee’s family receives IV-A cash payments. A Medicaid only case is a case where the
obligee’s family receives Medicaid but does not receive TANF (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 IV-D 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

identifier, and Tribunal number.
Under “IV-D case identifier”, enter the number/identifier identical to the one submitted on the Federal Case
Registry, which is a left-justified 15-character alphanumeric field, allowing all characters except asterisk and
backslash, and with all characters in uppercase. Under “tribunal 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 number, and E-Mail address.
• In the appropriate spaces, enter the Initiating jurisdiction’s FIPS code, State, and IV-D case identifier, and tribunal

number.
Under “IV-D case identifier”, enter the number/identifier identical to the one submitted on the Federal Case
Registry, which is a left-justified 15-character alphanumeric field, allowing all characters except asterisk and
backslash, and with all characters in uppercase. Under “tribunal number”, you may enter the docket number,
cause number, or any other appropriate reference number which the initiating tribunal or agency has assigned
to the case. The initiating jurisdiction is the jurisdiction that referred the case to the responding jurisdiction for
services.
• In the space marked “Send Payments To:” enter the address to which payments should be sent, if the address is

different from the agency address provided on the form in the space above.

Instructions for Child Support Enforcement Transmittal #2 – Subsequent Actions

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•

In the appropriate spaces, enter the FIPS code and State where payments should be sent.

• If funds can be transmitted electronically via Electronic Funds Transfer (EFT), enter the bank account number under

“Bank Account” and the bank routing code under “Routing Code”.

SECTION I (page 1), ACTION:
Check the appropriate box(es) to indicate which actions are requested or what information is being provided. Multiple
boxes may be checked, as appropriate.
• Check item 1 “Status Request” if you are asking for a status update. Describe the request in Section II.
• Check item 2 “Status Update” if you are providing a status update. Provide the update in Section II.
• Check item 3 “Notice of Hearing” if you are providing notice of an upcoming hearing. Provide dates and other
information in Section II.
• Check item 4 “Notice of Case Forwarding” if you are providing notice that you have forwarded a misdirected case to
the appropriate jurisdiction. Explain in Section II.
• Check item 5 “Document Filed” if you are providing notice that a document has been filed. Explain in Section II.
• Check item 6 “Order Issued/Confirmed” if you are providing notice that an order has been issued or confirmed. Attach
a copy of the order. If using CSENet, mail or FAX as separate item.
• Check item 7 “Notice of Arrearage Reconciliation/Determination of Sum-Certain” if you are providing notice of an
arrearage reconciliation or determination of sum-certain. Attach any calculations or worksheets used. If using CSENet,
mail or FAX as separate item.
• Check item 8 “Change IV-D Payee of Responding Tribunal Order” to request a change of payee in a IV-D case.
Describe your request in Section II “Additional Information”.
This is an administrative action used when the person or agency entitled to receive funds has changed. It may
occur with a change in public assistance or foster care status or if there is a change in custody. In some States,
court action, such as a modification, may be required if there is a change in custody or foster care status.
• Check item 9 “Redirect Payment to Obligee State” when the custodian has moved.
This is an administrative action, but in some States a court action may be required if the custodian’s move
compels transfer of documents or funds to another jurisdiction.
 Check item 10 “Other” if you are requesting a service or providing information other than the types listed. This would

include a new nondisclosure finding by the tribunal in either the initiating or the responding State. Describe the service
or information in Section II.
 Check the box beside “Please Return the Acknowledgment Attached” if an acknowledgment is needed. This is used
only if requesting information or action.

SECTION II (page 1), ADDITIONAL INFORMATION:
In this section, provide additional information which may be useful.
If there is an order preventing disclosure of a party’s or child’s address/identifying information, check the box for
“Nondisclosure Finding Attached” and attach a copy of the finding. You do not need to resend a finding that was sent
before. Note in Section II that the finding has already been sent. In accordance with the finding, do not provide the
address/identifying information; you may provide a substitute address.
A nondisclosure finding means a finding that the health, safety, or liberty of a party or child would be unreasonably
put at risk by disclosure of identifying information (e.g., residential address). UIFSA provides that interstate petitions
must include certain identifying information regarding the parties and child(ren) unless a tribunal (court or agency)
makes a nondisclosure finding by ordering that the address or identifying information not be disclosed. The
procedures for obtaining a nondisclosure finding vary from State to State.
At the bottom of page 1, provide a specific worker’s name, a direct telephone number (with extension if necessary), FAX
number and E-Mail address to expedite communications between jurisdictions.

Instructions for Child Support Enforcement Transmittal #2 – Subsequent Actions

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PAGE 2, ACKNOWLEDGMENT:
When a jurisdiction sends a Transmittal #2 to another jurisdiction, it should include the acknowledgment only if the
jurisdiction is requesting information or action. The sending State completes the Heading/Caption on this page. If the
jurisdiction is sending the Transmittal #2 to provide notice or information, the acknowledgment is not needed.
Upon receiving a request for action or information on a Transmittal #2, the receiving State completes the rest of the
acknowledgment. The acknowledgment can be used to provide any information requested on the Transmittal #2
or to indicate when (how many days or on what date) the requested information will be provided. The jurisdiction
sending the acknowledgment must indicate where the case has been referred for action, and the name, telephone,
FAX number and E-Mail address of a contact person.

The Paperwork Reduction Act of 1995
This information collection is conducted in accordance with 42 U.S.C. 651 et seq. and 45 CFR 303.7 of the child
support enforcement program. Standard forms are designed to provide uniformity and standardization for interstate
case processing. Public reporting burden for this collection of information is estimated to average under half an
hour per response. The responses to this collection are mandatory in accordance with the above statute and
regulation. This information is subject to State and Federal confidentiality requirements; however, the information
will be filed with the tribunal and/or agency in the responding State and may, depending on State law, be disclosed
to other parties. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number.

Instructions for Child Support Enforcement Transmittal #2 – Subsequent Actions

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