General Testimony (Page 25 of 30) in pdf

The payment history tables on the rest of page 6a should show arrears that accrued since the date

that arrears were adjudicated, or since the support order was entered if arrears have not been

adjudicated. The beginning balance for the first year's table should be the amount of adjudicated

arrears listed at the top of the page.

At the bottom of the page, enter the total amount of adjudicated and accrued arrears; indicate the date

that the amount is correct. If the amount of adjudicated arrears was used as the beginning balance in

the first year's payment history table, the ending balance in the last year's payment history table

should equal the amount of adjudicated and accrued arrears that is entered at the bottom of the page.

If continuation sheets are necessary, attach as needed. Each page of payment history should be

certified or notarized according to the standard required by the State or local agency in preparing an

interstate support pleading. The signature line can be signed either by a tribunal/agency representative

or an individual, depending on State procedures. Some responding States may require a seal to be

affixed if the records are provided by a tribunal or agency.

SECTION VIII, OBLIGEE'S PUBLIC ASSISTANCE STATUS: Complete this section only if:

You are seeking support for a prior period and public assistance was paid, or

You are seeking reimbursement for medical costs.

Otherwise, skip to section IX, Financial Information.

Complete items 1 and 2 only if you are seeking support for a prior period (i.e., if you are seeking "back

support" or support for a period prior to the establishment of an order). The award of support for a

prior period is not required under Federal law but may be appropriate in accordance with State law.

Not all States have authority to establish support orders for prior periods. However, the period of time

the family received public assistance may be a relevant factor in setting an award for a prior period;

this section provides space for this information.

States may not, as a federally-reimbursable function, establish judgments solely for reimbursement of

public assistance, or pursue enforcement of such judgments established after March 22, 1993. States

must use guidelines as a rebuttable presumption, not the amount of unreimbursed public assistance, in

establishing orders after October 13, 1989. States may establish child support awards covering a prior

period, but such awards must be based on guidelines and take into consideration either the current

earnings and income at the time the order is set, or the obligor's earnings and income during the prior

period.

Item 1: If known, specify the period of time when public assistance was paid to the obligee's family,

and the State which provided the assistance and had an assignment of support rights. Only consider

public assistance paid to the obligee or the children in this action (listed in section V).

Item 2: If known, enter the total amount of public assistance paid, and the date as of which the

amount was correct. Only include public assistance paid to the obligee or the children in this action

(listed in section V).

Item 3: Complete item 3 only if you are seeking reimbursement for medical assistance related to

prenatal, postnatal or general expenses. Enter the dollar amount of medical expenses for which you

are seeking reimbursement. Enter the name of the agency or person who paid the medical expenses

and is due reimbursement. Attach appropriate proof or documentation, such as receipts.

SECTION IX, FINANCIAL INFORMATION: This section is used to obtain information needed to apply

guidelines to determine the appropriate amount of support.

Instructions for General Testimony--Page 12

General Testimony Page 25