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NOTICE OF DETERMINATION OF CONTROLLING ORDER Date [ ] IV-D Non Public Assistance [ ] IV-D Non PA Medicaid Obligor (First, Mid, Last) [ ] Full Services [ ] Medical Services Only Obligee (First, Mid, Last) [ ] IV-D Public Assistance [ ] IV-E Foster Care (IV-D Case) [ ] Non-IV-D
To: (Agency Name and Address)

File Stamp

FIPS Code ________________________ State __________________________ IV-D Case No. ______________________________________________________ Docket No. _________________________________________________________ From: (Contact Person, Agency, Address, Phone, Fax, Internet) FIPS Code _________________________ State _________________________ IV-D Case No. ______________________________________________________ Docket No. _________________________________________________________

(Date), (Tribunal Name; County, State) determined 1. On which order to recognize for prospective enforcement. The following orders were considered:

# 1 2 3 4 5

County

State

Date of Order

IV-D Case Number

Docket Number

Order Type

[ ]

Additional orders listed on attached sheet.

2. The tribunal determined that order number ________ listed above in the table is the controlling order for prospective enforcement. 3.

[ ] [ ]

A copy of a modified order is attached. The tribunal determined that none of the existing orders is the controlling order. Therefore, a new order was entered; a copy is attached.
(Frequency)

4. $_______________ per ____________________________

is the current charging amount.
(Date).

5. The tribunal calculated arrears to be $________________ as of ______________________________

[ ]

Attached is a copy of the worksheet(s) showing the arrears calculation.

6. A copy of this notice (and any new or modified order) was also sent to: _______________________________________________________________________________________________
Entity Name; State

_______________________________________________________________________________________________

[ ] Obligor

[ ] Obligee

[ ] Additional Entities Listed on Attached Sheet
OMB No. 0970 - 0085 Page 1 of 1

Entity Name; State

Notice of Determination of Controlling Order

OMB No. 0970 - 0085

INSTRUCTIONS FOR NOTICE OF DETERMINATION OF CONTROLLING ORDER
PURPOSE OF THE FORM: When a tribunal makes a determination regarding which order is controlling for purposes of continuing, exclusive jurisdiction, this form is used to notify the parties and other tribunals/agencies of this determination. Under the Uniform Interstate Family Support Act (UIFSA), only the controlling order should be recognized for prospective enforcement (i.e., enforcement of current support). This form is designed to notify other tribunals/agencies when a tribunal makes a determination of which order is controlling, or when the tribunal issues a new child support order or modifies a child support order. When a new order is issued or an order is modified in accordance with UIFSA, the new order (or newly modified order) becomes the controlling order. This notice provides a standard format for alerting entities in other jurisdictions about a controlling order determination. The actual determination will likely be in a State-specific format (e.g. order or form) which may be attached to the standard Notice of Determination of Controlling Order if necessary. The Notice of Determination of Controlling Order provides the information about the controlling order in a uniform, standard format that will facilitate interstate processing. Complete this notice when your tribunal makes a determination of which order is controlling, or when your tribunal issues a new child support order or modifies a child support order. Generally, this form only needs to be used when there are multiple orders governing the same obligor/obligee/child(ren). If multiple orders governing the same obligor, obligee, and child(ren) exist, a UIFSA State can only prospectively enforce or modify the "controlling order" in a UIFSA proceeding. UIFSA contains rules for determining which order is recognized when multiple orders exist. Under these rules: 1. The order issued by a tribunal with continuing, exclusive jurisdiction (CEJ) has priority. As issuing tribunal retains CEJ as long as the issuing State remains the residence of the obligor, obligee, or child, or until all parties file written consent with the tribunal allowing another State to modify the order. 2. If more than one issuing tribunal would have CEJ, the order issued by the child's current home State has priority. 3. If more than one tribunal would have CEJ but there is no order in the child's current home State, the most recently issued order has priority. 4. If no tribunal would have CEJ, the responding State may issue a new support order and it becomes the CEJ State. While only the controlling order should be recognized for prospective enforcement, arrears that accrued under other orders may still be enforced. You must use the Notice of Determination of Controlling Order to notify: # the initiating IV-D agency if you are acting as a responding jurisdiction in an interstate action, # any tribunal that has issued, registered, or is enforcing a child support order governing the same parties and child(ren), # any IV-D agency with an open or closed IV-D case for the parties, # a party to the order (i.e., the obligor or obligee), as appropriate, or
Instructions for Notice of Determination of Controlling Order Page 1

# a central registry in another State. It may be particularly important to notify a central entity if it keeps a registry of all orders in that State. A central registry may also be willing to notify tribunals or agencies within that State. HEADING/CAPTION: # Enter the date of the notice. # Identify the obligor and obligee in the appropriate spaces. # Check the appropriate space to identify the type of case: IV-D Non Public Assistance; IV-D Non Public Assistance Medicaid (indicate whether receiving Full Services or Medical Services Only); IV-D Public Assistance; IV-E Foster Care; or Non IV-D. IV-D means the case is being worked by the State or local child support enforcement agency (i.e., IV-D agency). Public Assistance means the obligee's family receives IV-A cash payments [IV-A was formerly called Aid to Families with Dependent Children (AFDC) and is now called Temporary Family Assistance]. A IV-D Non Public Assistance Medicaid case is a case where the obligee's family receives Medicaid but does not receive Public Assistance (IV-A cash payments). # In the space marked "To:", list the name and address (street, city, State, and zip code) of the central registry, court, or agency where you are sending the Notice of Determination of Controlling Order. # In the appropriate spaces, if applicable and if known, enter the FIPS code, State, IV-D case number, and docket number of the jurisdiction to which you are sending the Notice. Under "docket number", you may enter the docket number, cause number, or any other appropriate reference number that the receiving State may use to identify the case, if known. # In the space marked "From:", list a contact person, agency name, address (street, city, State, zip code), phone number (including extension), fax number, and Internet address. # In the appropriate spaces, enter your jurisdiction's FIPS code, State, IV-D case number, and docket number. Under "docket number", you may enter the docket number, cause number, or any other appropriate reference number which the tribunal or agency has assigned to the case. MAIN BODY OF FORM: # In the first blank in item 1, enter the date that the determination of controlling order was made. In the second blank, enter the Name, County, and State of the tribunal which made the determination. # For each order considered in the controlling order determination, list in the table in item 1 the County, State, Date of Order, IV-D Case Number, Docket Number (enter docket number, cause number, or other appropriate reference number), and Order Type (e.g., de novo support, modification, dissolution, contempt, paternity, etc.). Include any order issued or modified by this tribunal in the present action. If more than five orders were considered, list and number additional orders on an attached sheet and check the space below the table which says "Additional orders listed on attached sheet". # In the blank in item 2, enter the number from the table (first column) of the order that was determined to be controlling. # In item 3, check the first box if a modified order was entered and is attached. Check the second box if a new order was entered and is attached.

Instructions for Notice of Determination of Controlling Order

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# In the blanks in item 4, enter the amount and frequency (e.g., week, month) of the current charging amount. # In the blanks in item 5, enter the amount of arrears and the date as of which the amount is correct. Check the box if a copy of any worksheet(s) used to calculate arrears is attached. Page 6a of the General Testimony may be used. # Under item 6, list the Name and State of other entities that you will be sending the notice to. If you will be sending the notice to all the tribunals listed in the table under number 1, you may write "All tribunals issuing orders listed in table above". List additional entities on an attached sheet if necessary, and check the box indicating that there is an attachment. If you are sending a copy of the Notice to the obligor and/or obligee, check the appropriate box(es) labelled "Obligor"/"Obligee".

****************************************** The Paperwork Reduction Act of 1995 This information collection is conducted in accordance with 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 one hour per response. The responses to this collection are mandatory in accordance with 45 CFR 303.7. 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 Notice of Determination of Controlling Order

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