Provision of Child Support Services in IV-D cases under the Hague Child Support Convention

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Statement of Enforceability of a Decision	Form and Instruction	Unchanged	Available
Form 1 Financial Circumstances Form	Form and Instruction	Unchanged	Available
Form 1 Status of Appliocation Report Article 12	Form and Instruction	Unchanged	Repair queued
Form 1 Application for Modification of a Decision	Form and Instruction	Unchanged	Available
Form 1 Status of Application Report	Form and Instruction	Unchanged	Available
Form 1 Application for Establishment of a Decision	Form and Instruction	Unchanged	Available
Form 1 Status of Application Report	Form and Instruction	Unchanged	Available
Form 1 Status of Application Report	Form and Instruction	Unchanged	Available
Form 1 Statement of Proper Notice	Form and Instruction	Unchanged	Available
Form 1 Statement of Enforceability of a Decision	Form and Instruction	Unchanged	Available
Form 1 Annex A: Abstract of a Decision	Form and Instruction	Unchanged	Available
Form 1 Application for Recognition or Recognition and Enforcement	Form and Instruction	Unchanged	Available
Form 1 Annex 2 Acknowledgement	Form and Instruction	Unchanged	Available
Form 1 Annex 1 Transimittal	Form and Instruction	Unchanged	Available
Supporting Statement Hague forms OCSE-0378.docx	Supporting Statement A	Uploaded 2016-12-14	Available
OCSE emergency clearance request - Hague forms 10-13-2016.docx	Supplementary Document	Uploaded 2016-10-20	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
224052	Annex B: Application for Enforcement of a Decision Made or Recognized in the Requested State, including restricted information on the applicant	Form and Instruction	Unchanged	Statement of Enforceability of a Decision
224050	Annex E: Financial Circumstances Form	Form and Instruction	Unchanged	Financial Circumstances Form
224049	Annex D: Status of Application Report-Article 12	Form and Instruction	Unchanged	Status of Appliocation Report Article 12
224048	Annex D: Application for Modification of a Decision, including Restricted Information on the Applicant	Form and Instruction	Unchanged	Application for Modification of a Decision
224047	Annex C: Status of Applicaiton Report-Article 12	Form and Instruction	Unchanged	Status of Application Report
224046	Annex C: Application for Establishment of a Decision, including restriced information on the Applicant	Form and Instruction	Unchanged	Application for Establishment of a Decision
224045	Annex B: Status of Application Report, Article 12	Form and Instruction	Unchanged	Status of Application Report
224044	Annex A: Status of Application Report	Form and Instruction	Unchanged	Status of Application Report
224043	Annex A: Statement of Proper Notice	Form and Instruction	Unchanged	Statement of Proper Notice
224031	Annex A: Statement of Enforceability of Decision	Form and Instruction	Unchanged	Statement of Enforceability of a Decision
224030	Annex A: Abstract of Decision	Form and Instruction	Unchanged	Annex A: Abstract of a Decision
224028	Annex A: Application for Recognition and Enforcement, including restricted including restricted information on the applicant	Form and Instruction	Unchanged	Application for Recognition or Recognition and Enforcement
224027	Annex II: Acknowledgment from under Article 12(3)	Form and Instruction	Unchanged	Annex 2 Acknowledgement
223996	Annex I: Transmittal form under Article 12(2)	Form and Instruction	Unchanged	Annex 1 Transimittal

ICR Details

OMB Control No: 0970-0488	ICR Reference No: 201612-0970-007
Status: Historical Active	Previous ICR Reference No: 201610-0970-010
Agency/Subagency: HHS/ACF	Agency Tracking No: OCSE
Title: Provision of Child Support Services in IV-D cases under the Hague Child Support Convention
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/12/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/16/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2020	36 Months From Approved	05/31/2017
Responses	19,116	0	19,116
Time Burden (Hours)	13,476	0	13,476
Cost Burden (Dollars)	0	0	0

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Abstract: On January 1, 2017, the 2007 Hague Convention on the International Recovery of Child Support and Other Forms of Family Maintenance (the Child Support Convention) will enter into force for the United States. On this date, U.S. States will begin to process child support cases with other countries that have ratified the Convention under the requirements of the Convention and article 7 of the Uniform Interstate Family Support Act (UIFSA 2008). In order to comply with the Convention, the U.S. must implement the Convention’s case processing forms.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 67355	09/30/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 89107	12/09/2016
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 14

table that charts list of burden

IC Title	Form No.	Form Name
Annex A: Abstract of Decision	1	Annex A: Abstract of a Decision
Annex A: Application for Recognition and Enforcement, including restricted including restricted information on the applicant	1	Application for Recognition or Recognition and Enforcement
Annex A: Statement of Enforceability of Decision	1	Statement of Enforceability of a Decision
Annex A: Statement of Proper Notice	1	Statement of Proper Notice
Annex A: Status of Application Report	1	Status of Application Report
Annex B: Application for Enforcement of a Decision Made or Recognized in the Requested State, including restricted information on the applicant	1	Statement of Enforceability of a Decision
Annex B: Status of Application Report, Article 12	1	Status of Application Report
Annex C: Application for Establishment of a Decision, including restriced information on the Applicant	1	Application for Establishment of a Decision
Annex C: Status of Applicaiton Report-Article 12	1	Status of Application Report
Annex D: Application for Modification of a Decision, including Restricted Information on the Applicant	1	Application for Modification of a Decision
Annex D: Status of Application Report-Article 12	1	Status of Appliocation Report Article 12
Annex E: Financial Circumstances Form	1	Financial Circumstances Form
Annex I: Transmittal form under Article 12(2)	1	Annex 1 Transimittal
Annex II: Acknowledgment from under Article 12(3)	1	Annex 2 Acknowledgement

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ICR Summary of Burden

table that charts list 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	19,116	19,116	0	0	0	0
Annual Time Burden (Hours)	13,476	13,476	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:

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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

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Common Form ICR:  No

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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: 12/16/2016

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