General Testimony (Page 30 of 30) in pdf

Check the other boxes to indicate any other items that are attached, including: a copy of the certified

child support payment records; copies of the three most recent paystubs from the current employer;

copies of bills for prenatal, postnatal, or general health care of mother and child; assignment or

subrogation of support rights; "Affidavit in Support of Establishing Paternity"; copy of child(ren)'s birth

certificates; an acknowledgment of parentage; and any other attachments (such as copies of bills for

parentage testing or the common law statute of the initiating State).

"Affidavit in Support of Establishing Paternity" is a standard interstate form completed by the

moving party [usually child(ren)'s mother or alleged father] who is seeking to establish the

alleged father's paternity of the child(ren). The form provides evidence regarding the father's

paternity. In interstate cases, a separate form must be completed for each child whose

paternity is at issue.

Acknowledgment of Parentage is an affidavit or form signed by the alleged father (and usually

the mother as well) voluntarily acknowledging the alleged father's paternity of the child(ren).

These forms are used by hospital-based programs, State child support agencies, and other

entities.

If the individual petitioner is indigent and unable to pay the costs of these proceedings, check the

“Other” checkbox and provide an explanation on the line provided. Note that checking this box does

not guarantee that the individual petitioner will be exempt from all costs and fees.

The person(s) providing the testimony -- the individual petitioner and/or agency representative -- should

sign and date the testimony at the bottom of page 10. Some States require the individual petitioner's

signature; check with the Interstate Roster and Referral Guide or the responding State to determine the

responding State's requirements. The form contains space for a notary to authenticate the signatures.

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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 General Testimony--Page 17

General Testimony Page 30