Instructions For Form Ldss-4882a - Information For An Additional Child printable pdf download

LDSS-4882A (7/12)

GENERAL INFORMATION

If you need language assistance, please visit the local Child Support Enforcement Unit so that language translation

and/or interpretation services can be provided.

INFORMATION ABOUT CHILD SUPPORT SERVICES

This document provides individuals interested in child support services with important information about the

program (Sections 1-6) and includes a detachable application/referral for child support services. Section 1 identifies

who is eligible to receive child support services, explains the assignment of support rights and cooperation, and

provides a summary of child support services and the basic child support obligation. Section 2 discusses rights and

responsibilities resulting from paternity establishment and right to notice of legal proceedings. Section 3 provides the

State's child support policies. Section 4 discusses legal services and cost recovery. Section 5 discusses the annual

service fee and Section 6 provides payment and contact information.

This information must be provided to all applicants for child support services and to applicants and recipients of

Temporary Assistance for Needy Families (TANF), Medicaid and Title IV-E Foster Care who are referred to the

Child Support Enforcement Unit. If the child is in foster care, the applicant or recipient is the Commissioner or

Designee of the social services district or the Commissioner or Designee of the Office of Children and Family

Services.

SECTION 1 – ELIGIBILITY, ASSIGNMENT, AND AVAILABLE SERVICES

ELIGIBILITY FOR CHILD SUPPORT SERVICES

Any parent or nonparent caregiver acting as guardian of at least one child under the age of 21 is eligible to apply for

child support services. Such person is considered the custodial parent in the child support case. If you are applying

for, or receiving, Temporary Assistance (officially termed “Family Assistance” or “Safety Net Assistance”) for the

child, child support services may be provided to you based on your application for this program. Child support

services may also be provided if you are applying for Medicaid for yourself and the child and you complete an

application/referral for child support services. Child support services will continue after you stop receiving

Temporary Assistance or Medicaid unless you request your child support case be closed. Child support services are

also provided for a child placed in foster care and may continue after the foster care placement ends. If the child

returns to you after being discharged from foster care, child support services will continue unless you request

otherwise. A child under the age of 21 or a noncustodial parent or putative (alleged) father may also apply or be

eligible for child support services.

ASSIGNMENT AND COOPERATION WITH CHILD SUPPORT

If you are an applicant/recipient of Temporary Assistance for the child, or Medicaid for yourself and the child, or

your child is in Title IV-E Foster Care, you are required to assign to the social services district rights you have to

support on your own behalf and any rights to support on behalf of any family member for whom you are applying

for, or receiving assistance. For Medicaid applicants/recipients, this assignment is limited to medical support only.

When applying for, or receiving Temporary Assistance, your assignment of support rights is limited to support that

accrues during the period that you or the family member receives assistance. You are required to assign these support

rights and, unless you claim good cause or domestic violence for not doing so, cooperate with the Child Support

Enforcement Unit to:

• Locate noncustodial parents and putative fathers, including biological parents or stepparents;

• Establish paternity for each child born out-of-wedlock for whom you are applying for, or receiving Temporary

Assistance, Medicaid, or Title IV-E Foster Care;

• Establish, modify, or adjust orders of support; and

• Collect and enforce orders of support through the Support Collection Unit.

If you are receiving Temporary Assistance for the child or Medicaid for yourself and the child, you will be

sanctioned for failing to cooperate absent a determination of good cause or domestic violence, if applicable.

CHILD SUPPORT SERVICES PROVIDED

The following services are provided by the Child Support Enforcement Unit as appropriate, with your cooperation:

• Establishment of a case record.

childsupport.ny.gov

Instructions For Form Ldss-4882a - Information For An Additional Child

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