State Referral For Federal Criminal Prosecution (Page 3 of 3) in pdf

State Referral For Federal Criminal Prosecution Page 3

SECTION VII – OTHER ELEMENTS

1. What other enforcement efforts/remedies have been attempted? Please list below and include dates and systems you may have used.

_____________________________________________________________________________________________________________________________________

2. Provide information relevant to establishing that the obligor has traveled interstate or internationally for the purpose of evading child support. Append supporting

documentation, including any tribunal order making such a finding.

______________________________________________________________________________________________________________________________________

Please attach separate sheet outlining this information, if available (Indicators or history of willful non-payment, ability to make full or partial payment,

obligor knows obligation exists or other circumstances)

SECTION VIII - REFERRAL/GRANT OF AGENCY:

SIGNATURE OF AUTHORIZED OFFICIAL

The referring IV-D agency certifies:

• The case is believed to meet statutory criteria for federal prosecution under 18 U.S.C.§228;

• The State has exhausted all available and reasonable alternative enforcement remedies;

• A request to OCSE for W-2 data was submitted and any W-2 information received from OCSE has

been independently verified;

• Only the W-2 employment data verified and provided by the child support agency is included with

this referral.

The signatory below warrants and represents that by this referral, PSOC is granted a limited agency to act on

behalf of the referring child support enforcement agency in the above-listed case, and solely for the purpose