General Testimony (Page 26 of 30) in pdf

Generally, you only need to complete this section if you are requesting establishment of an order or

modification of an existing order, unless a responding State specifically asks for section IX to be

completed to enforce an order. It is important to disclose all the information pertaining to income,

expenses, and assets, as required by the responding State's guidelines. Failure to disclose information

may seriously affect the legal proceedings in the responding State and may unnecessarily delay the

resolution of the support issue.

However, before completing all parts of Section IX you may wish to consult the Interstate Roster and

Referral Guide or to contact the responding State to determine if all parts of Section IX are needed.

Some responding States do not need all of the information in Section IX. You need to complete only

those parts needed by the responding State.

Part A: Monthly Income From All Sources

Item 1: Check the appropriate box to indicate if the individual petitioner is employed. If "yes", list

occupation. If "no", list income source.

Item 2: List the gross monthly income of the individual petitioner, the petitioner's current

spouse/partner (if applicable), and the obligor's dependents who are in the petitioner's custody. If

there are multiple dependents in the petitioner's custody, combine the income from all the dependents

and enter the total in the third column. List each income source separately under the categories

provided in item 2. Be sure to provide information regarding all earnings and income sources, including

salaries, wages, commissions, fees, bonuses, tips, and public assistance. You should consider

seasonal or intermittent income on an annual basis (total for the year divided by 12).

Item 2.a.: Enter the gross monthly amount of any public assistance received, including SSI,

Family Assistance, and other. "Family Assistance" means IV-A cash payments [IV-A was

formerly called Aid to Families with Dependent Children (AFDC) and is now called Temporary

Family Assistance]. "Other" includes other types of cash public assistance.

Item 2.b.: Enter the gross monthly amount of base pay salary or wages.

Item 2.c.: Enter the gross monthly amount of overtime, commissions, tips, bonuses, parttime

pay.

Item 2.d.: Enter the gross monthly amount of unemployment compensation received.

Item 2.e.: Enter the gross monthly amount of worker's compensation received.

Item 2.f.: Enter the gross monthly amount of Social Security Disability received.

Item 2.g.: Enter the gross monthly amount of Social Security Retirement received.

Item 2.h.: Enter the gross monthly amount of dividends and interest received.

Item 2.i.: Enter the gross monthly amount of trust/annuity income received.

Item 2.j.: Enter the gross monthly amount of pension or retirement income received.

Item 2.k.: Enter the gross monthly amount of any child support payments received.

Item 2.l.: Enter the gross monthly amount of any spousal support/alimony received.

Instructions for General Testimony--Page 13

General Testimony Page 26