NEW YORK STATE

OFFICE OF TEMPORARY AND DISABILITY

ASSISTANCE
40 NORTH PEARL STREET
ALBANY, NY 12243-0001

David A. Paterson
Governor

Administrative Directive
Section 1
Transmittal: 10-ADM-04
To:Local District Commissioners
IssuingCenter for Child Well-Being (CCWB)/Division of Child Support Enforcement
Division/Office:Center for Employment and Economic Supports (CEES)
Date:June 18, 2010
Subject: Increase in the Pass-through and Disregard of Support Payments – Phase II
Suggested Child Support Enforcement Coordinators
Distribution:Support Collection Unit Supervisors
Temporary Assistance Directors
Employment Coordinators
Staff Development Coordinators
Accounting Staff
Resource and Recovery Staff
Food Stamp Directors
Medicaid Directors
Foster Care Supervisors
Child Care Unit Supervisors
IV-D Attorneys
DSS Attorneys
Contact Division of Child Support Enforcement at 1-800-343-8859
Person(s): Temporary Assistance Bureau at 1-800-343-8859, extension 4-9344
Office of Legal Affairs – Susanne H. Dolin (518) 474-9502

Fiscal:

Regions 1-4: Edward Conway 1-800-343-8859 ext. 4-7549 or (518) 474-7549

Edward.Conway@otda.state.ny.us

Region 5: Michael Borenstein (212) 961-8251

Michael.Borenstein@otda.state.ny.us

Region 6: Marian Borenstein (212) 961-8250

OTDA 10-ADM-04 1
(Rev. 6/2010)
 Marian.Borenstein@otda.state.ny.us
Attachments: Attachment 1: Manual Child Support Pass-Through Payment Determination
Worksheet
Attachment 2: Examples for Determining the Amount of Pass-Through/Disregard
Provided to Temporary Assistance Families Effective January 1, 2010
Attachment 3: LDSS-3677, Report of Support Collected
Attachment 4: LDSS-3677-SP, Report of Support Collected
Attachment 5: LDSS- 3677 NYC, Report of Support Collected
Attachment 6 LDSS- 3677 NYC SP, Report of Support Collected
Attachment 7 LDSS-4279, Notice of Responsibilities and Rights for Support
Attachment 8: LDSS-4279 SP, Notice of Responsibilities and Rights for Support
Attachment 9: LDSS-3908, Important Notice Regarding Child Support to Persons
Applying for or Receiving Temporary Assistance or Foster Care Maintenance
Payments Under Title IV-E
Attachment 10: LDSS-3908-SP, Important Notice Regarding Child Support to
Persons Applying for or Receiving Temporary Assistance or Foster Care
Maintenance Payments Under Title IV-E
Attachment Available On –
Line:

Filing References

Previous Releases Dept. Soc. Serv. Manual Ref. Misc. Ref.

ADMs/INFs Cancelled Regs. Law & Other
Legal Ref.
92- ADM-40 18 NYCRR SSL 111-c ABEL Manual Schedule D-8
99-ADM-5 347.12; (2)(d);
06-ADM-16 347.13; SSL 131-a Food Stamp Dear TA Director
08-ADM-08 347.25; (8)(a)(v) Source Book Letter dated
09-ADM-04 352.15; SSL 336-c (FSSB) November 17, 2005
09-ADM-11 352.15(b);
09-ADM-21 352.15(d); Temporary Dear TA Director
10-ADM-01 352.22(t); Assistance Letter dated January
00-INF-2 352.31(a)(4); Source Book 4, 2006
352.31(v); (TASB)
369; GIS 06 TA/DC024
370; Fiscal dated July 10, 2006
387.10; Reference
387.11 Manual, GIS 09 TA/DC017
Volumes 2, 3, dated July 7, 2009
and 4
GIS 09 TA/DC030
PICS Manual dated October 21,
2009
TA and FS
Employment GIS 09TA/WMS038
dated December 23,
Policy Manual 2009

Dear Colleague
OTDA 10-ADM-04 2
(Rev. 6/2010)
 Letter dated June 15,
1990

Dear Colleague
Letter dated August
6, 1992

Dear Colleague
Letter dated October
26, 1993

Dear Colleague
Letter dated April
22, 2008

Child Support
Enforcement
“Continuation of
Services Notice”

ABEL Transmittal
09-5 dated October
8, 2009

ABEL Transmittal
10-1 dated January
5, 2010

Section 2

I. Summary

This Administrative Directive (ADM) advises local Support Collection Units (SCUs) and Social
Services Districts (SSDs) of the implementation of Phase II of legislation which increased the
pass-through payment and disregard amount from $100.00 to $200.00 effective January 1, 2010,
for Temporary Assistance (TA) families with two or more children. This ADM also advises
SSDs of the TA budgeting changes which must be applied to spousal support income in
conjunction with the new pass-through payment and disregard policy.

Information regarding the impact of the Phase II changes upon various program areas, including
Child Support, TA, Food Stamps, and Medicaid (MA) is provided. Additionally, official notices,
publications, and financial reporting changes, all impacted by the changes to how a pass-through
payment and disregard amount will be determined, and increases in the maximum monthly
amount of the pass-through and the disregard amount for a TA household with two or more
children, are addressed in this ADM.

OTDA 10-ADM-04 3
(Rev. 6/2010)
II. Purpose

The purpose of this ADM is to advise SCU and SSD staff of changes in the pass-through
payment and disregard amount which became effective January 1, 2010, and to provide specific
information regarding the impact of the change upon each program area. Changes discussed in
this ADM include the (1) method by which a pass-through payment and disregard amount is
determined for a TA family; (2) an increase in the amount of current support collected each
month that may be passed through and disregarded for purposes of determining the eligibility for
assistance; and (3) discontinuance of pass-through and disregard amounts associated with
spousal support.

III. Background

The Federal Deficit Reduction Act (DRA) of 2005 contains an optional provision under which
states may pass through an amount up to the first $100.00 of current support collected per month
for families with one child and up to the first $200.00 of current support collected per month for
families with two or more children to current-assistance families without paying to the Federal
government the federal share of the amounts passed through, as long as both the federal and state
share of the pass-through is paid to the family and is disregarded in determining the amount of
assistance provided to the family. As discussed in 08-ADM-08, dated October 29, 2008, and
entitled Increase in the Pass-through and Disregard of Support Payments, Social Services Law
§§111-c(2)(d) and 131-a(8)(a)(v) were amended by Part Z of Chapter 57 of the Laws of 2008 to
take advantage of this optional provision within the DRA. These statutory amendments reflect
the respective increases to the amount of the pass-through and the amount of income disregarded
for purposes of determining the standard of need and assistance provided through the TA
programs, including Family Assistance (FA) and Safety Net Assistance (SNA).

As stated in 08-ADM-08, the legislation provided for implementation of the pass-through and
disregard option in two phases. Phase I, which was implemented October 1, 2008, systematically
increased the amount of pass-through and disregard to an amount up to the first $100.00 of
current support collected each month by the child support enforcement program, or up to the
current support obligation collected each month, whichever is less. In Phase II, an amount up to
the first $100.00 in current support collected each month will continue to be passed through and
disregarded for TA households with one child, but the pass-through payment and disregard
amount will increase to an amount up to the first $200.00 per month of current support collected
each month for TA households with two or more children, or up to the current support obligation
collected, whichever is less. Phase II became effective January 1, 2010. This ADM provides
detailed information relating to Phase II of the implementation.

Pass-through means an assigned support collection applied to current support that the State
elects to pay to a family on assistance rather than retain to reimburse assistance granted. Current
support means, with respect to amounts collected as support on behalf of a family, the amount
designated as the monthly support obligation of the noncustodial parent in the order requiring the
support or as calculated by the State based on the order. The TA program meets the child
support pass through requirement by issuing Payment Type Codes “D1” (IV-D Payment) for
Rest of State (ROS), or “54” (Child Support Bonus Payment - Manual Issuance) and “70” (Child
Support Bonus Payment - System Generated) for New York City (NYC) in TA households where
OTDA 10-ADM-04 4
(Rev. 6/2010)
 the support is collected and retained by the SSD, or by issuing Payment Type Code “18” (Child
Support Disregard) in ROS for TA households who receive direct support.

The disregard is an amount of child support income received by a family equivalent to the pass-
through payment that is not considered by the TA program for the purposes of determining
eligibility for and the amount of assistance from the State that is provided to the family. When
determining eligibility for TA, current support must be budgeted as if the TA household received
direct support. TA meets the child support disregard requirement by disregarding up to the first
$100.00 or $200.00 of current support as countable income.

For the purposes of determining the pass-through and disregard amount of child or combined
child and spousal support collections, TA household means the TA case (referred to for child
support purposes as the TA-CAN); family means members of the TA household included on the
TA case; and child(ren) mean(s) any individual under the age of twenty-one who is an active
member of the TA case, including those individuals subject to a pro rata or IV-D sanction.

IV. Program Implications

A. Child Support Enforcement

The Child Support Management System (CSMS) monthly disregard process has been
revised. CSMS will no longer determine the potential pass-through amounts on behalf of
TA. CSMS will instead provide the TA program with the monthly current support
collections, which include child or combined child and spousal support, and the total
monthly support obligation for all accounts associated with the TA-CAN on the CSMS
month end disregard data file. Additionally, where current support collections are
receipted in the two prior months but not processed until the current month, CSMS will
provide the TA program with those additional monthly current support collections to
apply towards that prior month to determine whether the TA household is entitled to
additional pass-through payments. The TA program will use the information in the IV-D
Payment Mass Reauthorization (MRB/A) process to systematically determine the amount
of pass-through which a TA household is entitled to receive.

As a result of the CSMS disregard process changes, the Disregard Informational Lists
discussed in the Dear Colleague Letters dated June 15, 1990, August 6, 1992, and
October 26, 1993, only now includes a section entitled $100 Disregard-Accounts with
Negative 71 or 72 Payments. All other sections of the report have been discontinued.

Additionally, as discussed in the Temporary Assistance Source Book (TASB), upon

completion of the monthly IV-D MRB/A process which authorizes pass-through
payments, WMS produces the IV-D MRB/A Eligible and Exception lists. Cases that
appear on the IV-D MRB/A Exception list will be sorted by unit. The SSD’s TA unit
(hereafter referred to as “TA unit”) is responsible to resolve all exceptions on the list
except those that appear on the exception list with IV-D listed as the unit (hereinafter
referred to as the MRB/A IV-D Exception list). Any exceptions that appear on the MRB/A
IV-D Exception list must be reviewed by the SCU.

OTDA 10-ADM-04 5
(Rev. 6/2010)
 Finally, changes related to the pass-through payment amounts and to procedures for the
desk review, including forms, worksheets, instructions and letters, will be provided under
a separate ADM.

B. IV-D MRB/A Process

The IV-D MRB/A process is a monthly automated process which determines, authorizes,
and issues IV-D pass-through payments to eligible TA households and re-budgets
affected Food Stamp cases due to IV-D Payment income.

Cases which are categorized as “eligible” for an automated pass-through payment are
reported on the IV-D MRB/A Eligible list and the pass-through payment will be issued
systematically during the IV-D MRB/A monthly process. Any cases where a IV-D
payment cannot be determined and/or authorized systematically will appear on the IV-D
MRB/A Exception list which requires manual review and actions.

The IV-D MRB/A process uses monthly current support collection data supplied by the
CSMS monthly disregard file to systematically authorize IV-D pass-through payments to
TA households for any one specific support month.

The IV-D MRB/A process categorizes cases as:

 Eligible for an automated IV-D payment (These cases will be placed on the IV-D
MRB/A Eligible list [WIV5CI]); or
 An exception when the case or budget information is unacceptable for automated
action. (These cases will be placed on the IV-D MRB/A Exception list
[WIV5CX]). For the various exception reasons that may appear on the IV-D
MRB/A Exception lists, please refer to the Automated Budgeting and Eligibility
Logic (ABEL) Manual available on CentraPort under Resources.

Cases that appear on the IV-D MRB/A Exception list will be sorted by unit. Any
exceptions that appear on the MRB/A IV-D Exception list must be reviewed by the SCU.
If the SCU identifies a case that is eligible for a pass-through payment, as provided in
Section IV(A) above, the SCU must provide the TA unit with the information required on
the Manual Child Support Pass-Through Payment Determination Worksheet
(Attachment 1) and the TA unit will complete the determination as to the appropriate
pass-through payment amount and take any other actions necessary. All other exceptions
on the IV-D MRB/A Exception list are to be resolved by the TA unit.

Unlike the IV-D MRB/A Eligible list, the IV-D MRB/A Exception list does not report Food
Stamp amounts because the Food Stamp portion of the case has not been re-budgeted by
the IV-D MRB/A process. TA units must resolve the exceptions and take necessary Food
Stamp re-budgeting and/or reauthorization action.

Printed IV-D MRB/A Eligible and Exception lists are transmitted through the Benefit
Issuance and Control System (BICS) each month. In addition, the IV-D MRB/A Eligible
and Exception lists results are available on WMS through the IV-D Inquiry selection on
the ABEL menu. The lists are in the same format regardless of the medium chosen for

OTDA 10-ADM-04 6
(Rev. 6/2010)
 display. TA units should print the IV-D MRB/A Eligible and Exception lists and retain a
copy for historical reference.

For more information on the IV-D MRB/A Eligible and Exception lists, refer to the ABEL
manual, Section I – Mass Rebudgeting, pp. 129-148.

C. Manual Child Support Pass-Through Payment Determination Worksheet for ROS

The Manual Child Support Pass-Through Payment Determination Worksheet

(Attachment 1) is a worksheet that must be completed for TA cases where the pass-
through payment determined through the monthly IV-D MRB/A process may require
adjustments. The Manual Child Support Pass-Through Payment Determination
Worksheet is an intra-departmental worksheet which must be completed by the SCU and
the TA unit. Part A of the worksheet is required to be completed by the SCU; Part B of
the worksheet is required to be completed by the TA unit.

The worksheet will allow TA units to identify TA cases where (1) the household is due
an additional pass-through payment amount for a given month or (2) a pass-through
payment was issued incorrectly for a given month, requiring establishment of an
overpayment. All follow up activities determined as a result of completing the worksheet
are required to be resolved within thirty (30) calendar days of the completion of the
worksheet, unless the case is indentified as appearing on the MRB/A IV-D Exception list.
Cases identified as appearing on the MRB/A IV-D Exception list must be resolved by the
twentieth (20th) calendar day of the month in which the list was received.

D. Examples for Determining the Pass-Through/Disregard Amounts

To assist local districts in determining the appropriate amount of pass-through a family

may be entitled to receive, Examples for Determining the Amount of Pass-
Through/Disregard Provided to Temporary Assistance Families Effective January 1,
2010 (Attachment 2) provides a variety of family situations encountered by TA units.
The case situations are established to identify the source of collections received and how
those collections are applied by the TA unit in determining the appropriate amount of
pass-through and/or disregard the family is entitled to after January 1, 2010.

E. Temporary Assistance

The changes in determining the pass-through and disregard amount will provide an
increase in the distribution of current support collections to TA families, and will increase
the amount of current child support collections that will be disregarded when determining
eligibility and the standard of need.

Categories of Support: For TA budgeting purposes there are two categories of support:

1. Court ordered support; and

2. Voluntary support.

OTDA 10-ADM-04 7
(Rev. 6/2010)
 Any support collected by or on behalf of a TA applicant/recipient will be considered
court-ordered support when there is an order of support issued by a court requiring the
noncustodial parent (NCP) to pay such support.

Any support collected by a TA applicant/recipient is considered to be voluntary support

when there is no order of support issued by a court requiring the NCP to pay such
support.

Types of Support: For TA budgeting purposes there are three types of support income:

1. Child Support, which represents support income from a noncustodial parent

(NCP) on behalf of a child;
2. Spousal Support, which represents support income from a former spouse for
the TA applicant/recipient; and
3. Combined Child and Spousal Support, which represents support income from
an NCP on behalf of both a child and a custodial parent.

Budgeting Child or Combined Child and Spousal Support Income (Direct Support
versus Assigned Support): Child or combined child and spousal support income is
entered in the TA ABEL budget based on how the support is received by the
applicant/recipient.

Child or combined child and spousal support income received by an applicant/recipient as

a result of (1) voluntary support; (2) court-ordered support made payable directly to the
applicant/recipient; or (3) court-ordered support made payable through the SCU, is
known as direct support and must be budgeted using unearned income source code “06”
(Child Support Payment) in ROS or code “14” (Court Ordered Alimony, Spousal
Support, Child Support Payment) in NYC. TA applicants receiving child or combined
child and spousal support income in the household will always be in receipt of direct
support at the time of application.

Child or combined child and spousal support income collected by the child support
enforcement program and retained by the TA unit on behalf of a TA recipient is known as
assigned support and must be budgeted using unearned income source code “13”
(Child/Spousal Assigned to Agency) in ROS, or code “61” (Alimony/Spousal/Child
Support Assigned to the Agency) in NYC. For both ROS and NYC, assigned support
must equal the court-ordered obligation amount when entered in the ABEL budget.

Change in Child or Combined Child and Spousal Support Disregard Amount:

Effective January 1, 2010, the first $100.00 per month of current child or combined child
and spousal support income (including support payments collected and paid to the family
by the child support enforcement program) received directly by households applying for
or receiving TA with one active child on the TA case must be disregarded in the
determination of eligibility or standard of need.

Households applying for or receiving TA with two or more active children on the TA
case must receive a disregard of the first $200.00 per month of current child or combined
child and spousal support received when determining TA eligibility or standard of need.

OTDA 10-ADM-04 8
(Rev. 6/2010)
 Note: For the purposes of determining the appropriate pass-through payment and
disregard amount, a child is defined as any individual under the age of twenty-one who is
an active member of the TA case, including those individuals subject to a pro rata or IV-
D sanction. Additionally, essential persons (EPs) and heads of household who are under
the age of twenty-one and on the TA case must be considered as a child for the purposes
of determining the number of children in the TA household.

Cases which include both direct and assigned support in the TA budget are entitled to
only one disregard of up to $100.00 or $200.00 based upon the number of children in the
TA household. For these cases, the TA unit must use the appropriate IV-D indicator code
of “X” on Screen 1 of the Welfare Management System (WMS).

Child support income received directly by the household must be included in the TA
budget until the child support enforcement program is able to accept and account for the
support. The SCU will notify the TA unit when such support collections have been
established and directed to the SSD by completing the LDSS-2859 Child Support
Information Transmittal. For more information see GIS 06 TA/DC024 (issued July 10,
2006) and 10-ADM-01, dated February 25, 2010, and entitled Changes to Assignment of
Rights and Child Support Distribution in Current Assistance Cases.

Example 1 - Direct support received and budgeted

Jane Jones and her two children, ages seventeen and ten, apply for TA on
January 15, 2010. Ms. Jones reported that she has no income other than
the $250 monthly child support payment she receives directly from the
father of the children on the first of every month. The first $200.00 of
child support income must be disregarded when determining eligibility or
standard of need since there are two children applying for TA. The
remaining amount is applied as income.

Change in Child or Combined Child and Spousal Support Pass-Through Amount:

Effective January 1, 2010, an amount up to the first $100.00 of current child or combined
child and spousal support income assigned and collected each month by the child support
enforcement program, or up to the current support obligation, whichever is less, must be
paid as a pass-through payment to TA households with one child active on the TA case.
The pass-through payment will increase to an amount up to the first $200.00 per month of
current child or combined child and spousal support income assigned and collected each
month by the child support enforcement program, or up to the current support obligation,
whichever is less, for TA families with two or more children active on the TA case.

Example 2 - Active case - assigned support

Tonya Raven and her three children, ages ten, eight, and four, are
currently on TA. Ms. Raven currently has a monthly child support order of
$300.00. Support payments have been collected regularly for the past
seven months by the child support enforcement program. Ms. Raven has
been receiving pass-through payments in the amount of $100.00 for each
of those months. Effective for current support collected in January 2010,

OTDA 10-ADM-04 9
(Rev. 6/2010)
 the pass-through amount increases to $200.00, which will be issued in
February 2010.

Determining Child or Combined Child and Spousal Support Pass-through and

Disregard Amounts: When determining the appropriate pass-through payment and
disregard amount for child or combined child and spousal support income, TA units must
first confirm that the TA household is in receipt of child or combined child and spousal
support and then determine the number of active children in the TA household. It is not
necessary for the TA unit to consider which member of the TA household the support
payments are received for when determining the pass-through payment and disregard
amount.

Changes to IV-D MRB/A Eligible and Exception Lists (ROS only): Beginning with
the February 2010 IV-D MRB/A process, the current monthly obligation for the IV-D
case and the amount entered in the EXEMPT field for unearned income source code
“13” in the ABEL budget for the current and two previous months will be reported to TA
during that month’s IV-D MRB/A process via the monthly IV-D MRB/A Eligible and
Exception lists. The TA unit must review both the IV-D MRB/A Eligible and Exception
lists. Both the IV-D MRB/A Eligible and Exception lists will have a third line added for
each case to display these new amounts under four new fields. Respectively, they will
appear under new headings that read as follows:

MONTH OBL (Current Monthly Obligation)

EXMT 2 (The amount used for the EXEMPT amount during the month
preceding the prior month’s IV-D MRB/A process, identified to as “Previous 2”)

EXMT 1 (The amount used for the EXEMPT amount during the prior month’s
IV-D MRB/A process, identified as “Previous 1”)

EXMT CUR (The amount used for the EXEMPT amount during the Current
Month’s IV-D MRB/A process)

For more information see ABEL Transmittal 09-5, issued October 8, 2009, under
Information #3. Additional changes to the IV-D MRB/A Eligible and Exception lists will
be released in a forthcoming Informational Letter (INF).

Change in Spousal Support Disregard Amount: Effective January 1, 2010, spousal

support received by individuals as a result of an order providing only spousal support will
no longer receive any disregard.

Note: This change does not apply to combined child and spousal support as previously
defined in this Section.

Notices and Publications: Revisions have been made to required notices and
publications. TA units must destroy all prior versions of the identified forms, notices and
publications in Section V(B)(11) below and replace those documents with the versions of
the documents included with this ADM. Related changes to the desk review process,

OTDA 10-ADM-04 10
(Rev. 6/2010)
 including forms, worksheets, instructions and letters, will be provided under a separate
ADM.

F. Transitional Employment Advancement Program Implications

Transitional Employment Advancement Program (TEAP) is a form of subsidized

employment in which all or a portion of the TA benefits otherwise payable to the
household are diverted to an employer for a designated period of time (not to exceed
twelve (12) months) to support a paid work opportunity for a TA recipient. As discussed
in 09-ADM-11, dated June 19, 2009, and entitled Transitional Employment Advancement
Program (TEAP), the TA case for households which include an individual participating
in TEAP, including those households that receive a $0 TA grant, remain open during the
TEAP contract period and would therefore continue under an assignment of support
rights and must cooperate with the child support program to establish paternity and
establish, modify, and enforce orders of support consistent with other open TA cases. TA
cases that include an individual participating in TEAP are eligible to receive a pass-
through payment, which is disregarded from the TA budget to the same extent as in other
TA households.

G. Food Stamps

The Food Stamp policy regarding the treatment of pass-through payments has not
changed; only the maximum amount of the pass-through that must be treated as income
for Food Stamp purposes for households with two or more children for whom support
payments are being received has changed. For households with two or more children for
whom support payments are being received, the first $200.00 of current support payments
that are passed through to the TA recipient is countable as income for Food Stamp
purposes. The remainder of child or combined child and spousal support payments
received by the IV-D program under an assignment continue to be excluded as income to
the Food Stamp household.

For households with one child in the household for whom support payments are being
received, the policy remains unchanged from that stated in 08-ADM-08. As noted above,
the pass-through amount for families receiving support payments for one child remains at
$100.00, and it is only this pass-through amount of the support payment that is counted as
income for Food Stamp purposes. The remainder is excluded.

H. Medicaid

As discussed in 08-ADM-08, effective October 1, 2008, for Low Income Families (LIF),
Single Individuals and Couples (S/CC), and Aid to Dependent Children (ADC)
budgeting, the first $100.00 of current total household support payments is disregarded,
including support payments collected and paid to the family by the child support
enforcement program in any month. There will be no change to the $100.00 disregard for
purposes of MA budgeting. Households that are TA eligible will still remain eligible for
MA.

OTDA 10-ADM-04 11
(Rev. 6/2010)
 The Medicaid Automated Budget and Eligibility Logic (MBL) system support is now
available and is budgeting the $100.00 disregard where the additional deduction affects
eligibility when doing LIF, S/CC or ADC budgets.

I. Foster Care

For purposes of Title IV-E Foster Care and Non-IV-E Foster Care, there is no impact to
the program.

J. Child Care

For purposes of Child Care, there is no impact to the program.

V. Required Action

A. Child Support Enforcement

1. Reviewing the Monthly Disregard Informational Listing

a. SCUs are to continue to review the monthly CSMS produced Disregard

Informational List for $100 Disregard-Accounts with Negative 71 or 72
Payments, as discussed in the Dear Colleague Letters dated June 15, 1990,
August 6, 1992, and October 26, 1993. The listing, which is produced by
CSMS at the end of each calendar month and stored on the Computer
Output to Laser Disc (COLD) system, includes accounts on which a
negative batch 71 or 72 was processed for a disregard eligible ledger or at
case level.

b. The accounts listed on the report must be reviewed to determine if the

negative payments affect the amount of pass-through payment created
during the IV-D MRB/A process. Where the negative 71 or 72 payment
transaction will affect the amount of pass-through payment, the SCU must
use the procedure outlined in Section V(A)(3) to advise the TA unit so that
the pass-through payment can be issued appropriately.

2. Reviewing the Monthly MRB/A IV-D Exception List

a. After the monthly IV-D MRB/A process is completed, pass-through

payments which could not be processed due to criteria within CSMS will
be reported on the MRB/A IV-D Exception list. SCUs must obtain this
sub-portion of the IV-D MRB/A Exception list through their local SSD
BICS operator.

b. Where a case is reported on the MRB/A IV-D Exception list, SCUs must
perform the required actions on the CSMS account to resolve the situation
and to determine whether there are assigned support collections applied to
disregard eligible ledgers which should result in the issuance of a pass-
through payment for the current month or any past months that have been
OTDA 10-ADM-04 12
(Rev. 6/2010)
 impacted by required actions. Where the SCU determines after the CSMS
account has been resolved that assigned support collections have been
applied to disregard eligible ledgers and a pass-through should be issued,
the SCU must advise the TA unit of the current support obligation amount
and the current support collections applied to those disregard eligible
ledgers so that the pass-through payment can be determined by the TA
unit and issued appropriately.

3. Advising TA Unit of Potentially Incorrect Pass-through Payment Amount

a. Where the SCU determines that a pass-through payment is potentially

incorrect or requires a determination through review of the monthly
Disregard Informational List or the IV-D MRB/A Exception list, or for any
other reason, the SCU must provide required information to the TA unit so
that the TA unit can determine the actions necessary to correct the pass-
through payment. The SCU must advise the TA unit by initiating a
Manual Child Support Pass-Through Payment Determination Worksheet
(Attachment 1) within five (5) business days of identifying that a review
is necessary.

b. The SCU must complete Part A of the worksheet as instructed. Part A of

the worksheet will provide the required information necessary to assist the
TA unit in determining the correct amount of the pass-through payment,
including the total of the current obligation amount(s) and the amount of
current support collections received for the month for each CSMS account
with the same TA-CAN. Upon completion, the SCU must forward the
worksheet to the respective TA unit to complete Part B.

4. Receiving Requests from the TA Unit for Pass-through Payment

Determinations

Where the TA Unit reviews the respective IV-D MRB/A Eligible and Exception
lists, or a TA case under daily operations, and determines that a review of pass-
through payment amounts must be conducted, a request for such review will be
sent to the SCU (see Section V[B][9] below). The SCU must initiate the review
by completing Part A of the Manual Child Support Pass-Through Payment
Determination Worksheet (Attachment 1) within five (5) business days of receipt
of the request and submitting the form to the respective TA unit.

B. Temporary Assistance

1. Determining Support Pass-through/Disregard Amounts

To perform the budgeting of the $100.00 and $200.00 pass-through payment and
disregard amount, TA units must determine the number of children under the age
of twenty-one who are active in the TA case. NYC WMS will be queried to
automatically determine the number of active children under the age of twenty-
one who are active in the TA case.

OTDA 10-ADM-04 13
(Rev. 6/2010)
 Note: For the purposes of determining the appropriate pass-through payment and
disregard amount, a child is defined as any individual under the age of twenty-one
who is an active member of the TA case, including those individuals subject to a
pro rata or IV-D sanction. Additionally, EPs and heads of household who are
under the age of twenty-one and on the TA case must be considered as a child for
the purposes of determining the number of children in the TA household.

a. ROS

TA budgets with either unearned income source code “06” or “13” will
require an amount of either $100.00 or $200.00 (if the case has more than
one active child under the age of twenty-one) entered in the associated
EXEMPT field of the ABEL input screen. The EXEMPT field will be
used to determine the appropriate pass-through/disregard amount:

TA families with one child under the age of twenty-one, who is active
on the case or subject to a pro rata or IV-D sanction, must have an
EXEMPT amount of $100.00 entered in the TA ABEL budget
input screen.

TA families with two or more children under the age of twenty-one,

who are active on the case or subject to a pro rata or IV-D sanction,
must have an EXEMPT amount of $200.00 entered in the TA
budget input screen.

Note: The current $100.00 EXEMPT limit will still continue to be used
for TA budgets with unearned income source code “06” that have a budget
FROM date prior to January 1, 2010, even if a $200.00 EXEMPT limit
amount is entered.

b. NYC

TA budgets with either unearned income source code “14” or “61” will be
programmed to automatically exempt an amount of either $100.00 (if the
case has one child under the age of twenty-one, who is active on the case
or subject to a pro rata or IV-D sanction) or $200.00 (if the case has more
than one child under the age of twenty-one, who is active on the case or
subject to a pro rata or IV-D sanction).

TA families with one child under the age of twenty-one, who is active
on the case or subject to a pro rata or IV-D sanction, will receive an
automatic exemption amount up to a maximum of $100.00.
TA families with two or more children under the age of twenty-one,
who are active on the case or subject to a pro rata or IV-D sanction,
will receive an automatic exemption amount up to a maximum of
$200.00.

OTDA 10-ADM-04 14
(Rev. 6/2010)
 2. Cases with Assigned Support in the ABEL Budget

a. ROS

For TA cases with assigned support in the TA ABEL budget, the monthly
IV-D MRB/A process will issue pass-through payments up to the first
$100.00 or $200.00 where current child or combined child and spousal
support income was collected. Households with child or combined child
and spousal support income received by the child support enforcement
program and reflected in the ABEL budget with unearned income source
code “13” will receive a pass-through payment of up to the first $100.00
of current child or combined child and spousal support collected, or up to
the current support obligation, whichever is less, if the budget contains an
EXEMPT amount of $100.00. If the ABEL budget contains an
EXEMPT amount of $200.00, the household will receive a pass-through
payment of up to the first $200.00 of current child or combined child and
spousal support collected or up to the current support obligation,
whichever is less.

b. NYC

For TA cases with assigned support in the TA ABEL budget, the monthly
IV-D MRB/A process will issue pass-through payments up to the first
$100.00 or $200.00 where current child or combined child and spousal
support income was collected. Households with child or combined child
and spousal support received by the child support enforcement program
and reflected in the ABEL budget with unearned income source code “61”
will receive a pass-through payment of up to the first $100.00 of current
child or combined child and spousal support collected, or up to the current
support obligation, whichever is less, if the case has one child under the
age of the age of twenty-one, who is active on the case or subject to a pro
rata or IV-D sanction. If the case has more than one child under the age of
twenty-one, who is active on the case or subject to a pro rata or IV-D
sanction, the household will receive a pass-through payment of up to the
first $200.00 of current child support or combined child and spousal
support collected or up to the current support obligation, whichever is less.

3. Pass-through Payment Line for Collections of Assigned Support

Effective February 2010, pass-through payments will be issued in an amount up

to the first $100.00 or $200.00 of current assigned support collected, whichever is
appropriate.

Automated pass-through payments issued as a result of the IV-D MRB/A process

will be issued using Payment Type Codes “D1” in ROS or “70” in NYC. Pass-
through payments issued manually must be issued using Payment Type Code
“D1” and Special Claiming Category Code “N – Non-reimbursable” in ROS or
“54” in NYC.

OTDA 10-ADM-04 15
(Rev. 6/2010)
 If the pass-through payment is made to the wrong individual, a payment to the
correct individual must be issued immediately and recovery or recoupment from
the incorrect individual must be made. Payment Type Code “56” (Child Support
Bonus Payment – Check Replacement) must be used when manually issuing
replacement pass-through payments in NYC.

4. Cases with Direct Support in the ABEL Budget

a. ROS

Effective January 1, 2010, households with child support income reflected

in the ABEL budget with unearned income source code “06” will have the
benefit of up to the first $100.00 exempt from countable income for the
household, if the ABEL budget contains an EXEMPT amount of $100.00.
If the ABEL budget contains an EXEMPT amount of $200.00, up to the
first $200.00 will be exempt from countable income for the household.

b. NYC

Effective January 1, 2010, households with child support income reflected

in the ABEL budget with unearned income source code “14” will have the
benefit of up to the first $100.00 exempt from countable income for the
household, if the ABEL budget contains one active child under the age of
twenty-one. If the ABEL budget contains two or more active children
under the age of twenty-one, up to the first $200.00 will be automatically
exempt from countable income for the household.

Example 3: Determining the Number of Children in the

TA Household

A TA household that contains a mother (age 32) and two

children (ages 5 and 7), is in receipt of child support and
receives FA. The child support income is being paid to the
mother directly. One child is in receipt of Supplemental
Security Income (SSI). When entering the EXEMPT
amount ROS in the TA ABEL budget input screen, the TA
unit determines that there are two children under the age of
21 in the family. However, only one of those children is
active on the TA case; therefore the TA unit enters $100.00
in the EXEMPT field and enters the appropriate unearned
income source code of “06.” In NYC, the TA ABEL budget
will only exempt $100.00 from the amount input with
income source code “14.”

Note: SSI individuals are not active members of a TA household.

OTDA 10-ADM-04 16
(Rev. 6/2010)
 5. Support Disregard Payment Line for Direct Support Received and Budgeted
(Case Types 11, 12, 16, and 17) (ROS only)

Effective January 1, 2010, to reflect the child support disregard amount, TA units
must reduce the semi-monthly grant in an amount equal to $50.00 or $100.00 (or
one-half of the disregarded amount), whichever is appropriate. TA units must
authorize a recurring semi-monthly payment in the amount of $50.00 or $100.00
(or one-half of the monthly child support disregarded) using Payment Type Code
“18” and Special Claiming Category Code “P-FNP Payment.” Edits require that
when a Payment Type Code “05” (Case Recurring Grant)” and a Payment Type
Code “18” are entered in a case that the sum of their associated amounts must
equal the semi-monthly or monthly grant amount in the stored ABEL budget. For
case type “16” and “17” there is no need to write the disregard as a separate
payment line. For more information see GIS 06 TA/DC024 and 10-ADM-01.

TA units must provide an underpayment adjustment for each month that support
was received directly by the TA household and counted as income in the TA
budget if the grant amount was based on only the $100.00 disregard in a month,
or months when the disregard should have been more than $100.00 (January
2010, or later).

When providing an underpayment adjustment to cases due disregard payments,

TA units must authorize the payment using Payment Type Code “18” and Special
Claiming Category Code “P-FNP PAYMENT” in households that are case type 11
(Family Assistance) and 12 (Safety Net Non-Cash Assistance [SNA-FP]). For
households in case type “16” (Safety Net Cash Assistance [SN-CSH]) or “17”
(Safety Net Non-Cash Assistance [SN-FNP]), the special claiming code is not
required.

6. Transition for Budgeting the Increase in Child Support Disregard Amount –

Directly Received Support

TA households with support directly received and reflected in the ABEL budget
with unearned income source code “06” in ROS or code “14” in NYC must have
the benefit of up to the first $100.00 or $200.00, as appropriate, disregarded even
if the ABEL budget is not recalculated to reflect the increased disregard amount
until after January 2010.

Since the pass-through is an amount up to $100.00 through December 31, 2009,

some households that become entitled to an amount up to $200.00 effective
January 1, 2010, may be due an underpayment adjustment during the transitional
period. This might occur during the time period when a correct income disregard
amount of up to $200.00 was not applied to the TA budget. As soon as possible,
but no later than the next client contact, TA units must review the ABEL budget
to determine if an underpayment adjustment is due to the TA household.

For TA households where support is received by the household directly, TA units

must manually update all ABEL budgets with an authorization “FROM DATE”

OTDA 10-ADM-04 17
(Rev. 6/2010)
 period earlier than 11/14/09, and if needed, issue an underpayment adjustment. A
TA household will be due an underpayment adjustment if the:

● ABEL budget has a TA authorization period “FROM DATE” before 11/14/09

and a “TO DATE” of 1/1/10 or later; and
● TA household received child or combined child and spousal support payments
directly for the month of January 2010, and any months thereafter, which is
greater than $100.00.

In ROS, the TA unit must review the case and provide an underpayment
adjustment by issuing the difference between what was issued as Payment Type
Code “18” and what should have been issued as Payment Type Code “18,” for
each month beginning January 2010 where the household should have, but did
not, receive the disregard amount of up to $200.00.

Note: The underpayment is not countable for Food Stamps.

Example 4 - Direct support received and budgeted

Joan James and her three children, ages 13, 8 and 3, apply for TA
on November 11, 2009. Ms. James reported that she has no income
other than the $300.00 monthly child support payment she receives
directly from the children’s father on the first of every month.

When determining the income eligibility of Ms. James’ household

on November 11, 2009, the date of case opening, the TA unit did a
partial month budget for November 2009 and full month budgets
for December 2009 and January 2010, counting the support in the
TA budget. The full month budget authorization “FROM DATE”
is December 1, 2009 and the “TO DATE” is January 31, 2010.
Beginning November 11, 2009, and through January 2010, the
budget reflected direct support paid directly to Ms. James. ABEL
will have disregarded only the first $100.00 of current support in
the ABEL budget for December and January. The TA unit must
provide an underpayment adjustment for the additional $100.00
that is due to the household for January 2010 when the appropriate
EXEMPT amount was not included in the ABEL budget. The
underpayment is not countable for Food Stamps.

7. Updating Child Support Unearned Income Source Codes

Once the TA unit becomes the beneficiary of an order of support (i.e. direct
support becomes assigned support), the district must immediately change the
unearned income source code “06” in ROS or code “14” in NYC to unearned
income source code “13” in ROS or code “61” in NYC, and not wait until the
expiration of the effective date of the current TA budget.

The effective date of the new stored budget must be the first day of the month
following the month in which the SCU notifies the TA unit that support is being
OTDA 10-ADM-04 18
(Rev. 6/2010)
 directed to the district and the agency is now the beneficiary of the support order.
The SCU must notify the TA unit of this information through the LDSS-2859
Child Support Information Transmittal. (See 10-ADM-01). For the month in
which the SCU notifies the TA unit that support is being directed to the district
and the agency is now the beneficiary of the support order, the TA unit must do
an underpayment adjustment as appropriate to account for the loss of the directly
received support and the effect it has on the amount of assistance the household is
eligible to receive. The underpayment adjustment must be issued as Payment
Type Code “07” (Underpayment Adjustment)..

The TA unit must evaluate how much direct support was received by the
household in the month in which the SCU began collecting the assigned support.
If the household received less support than what was budgeted as unearned
income source code “06” in ROS or code “14” in NYC due to the agency
becoming the beneficiary of the support order, the district must create a
scratchpad budget which includes the amount of support actually received by the
household in the month the support became assigned support. Compare the
scratchpad budget to the stored budget and if an underpayment occurred, issue the
difference as an underpayment adjustment for the month in which the support
became assigned support.

In NYC, the TA unit must re-budget the case with the amount of support actually
received by the household in the month the support became assigned support and,
where an underpayment adjustment is necessary, provide the difference with a
single issuance.

Note: For TA cases where the direct support was paid to the household by the
child support enforcement program the TA unit may contact the SCU to
determine the amount of support actually received by the household in the month
the support became assigned support.

8. Budgeting Spousal Support

Effective January 1, 2010, all TA recipients who have spousal support orders
must have their spousal support income budgeted as unearned income source code
“02” (Alimony/Spousal Support [Non-Arrears]) in ROS or new unearned income
source code “68” (Alimony/Spousal Support) in NYC. Both income source codes
will be counted as income for TA and Food Stamps. There will be no disregard
applied.

a. ROS

Alimony/Spousal support previously coded as “02” if paid to an individual

by an NCP who is also ordered to pay child support on behalf of a TA
applicant/recipient must be re-coded as unearned income source code “06”
in order to provide the individual with an EXEMPT amount to which they
would be entitled to receive. As of January 1, 2010, TA budgets will no
longer apply any income exemptions to alimony or spousal support

OTDA 10-ADM-04 19
(Rev. 6/2010)
 entered in the ABEL budget as unearned income source code “02” and
will therefore create a reduction in the TA grant effective January 1, 2010.

A listing of TA cases with unearned income source codes “02” and/or

“06” was provided to ROS TA units in early November 2009 to assist
districts in accomplishing this task.

b. NYC

If there is income from a spousal support order which is paid by an

individual who is not paying child support on behalf of a child within the
TA household or is budgeted as unearned income source code “14,” the
spousal support must be changed to unearned income source code “68.”
This action will result in a reduction in the TA grant effective January 1,
2010. Unearned income source code “68” will not apply any disregard or
income exemptions to spousal support income.

A listing of TA cases with unearned income source code “14” was provided to
NYC Human Resource Administration (HRA) at the end of October 2009 to assist
in preparation for this change.

9. Additional Responsibilities When Reviewing the Monthly IV-D MRB/A

Eligible List (ROS only)

When reviewing the monthly IV-D MRB/A Eligible list, the TA unit must compile
a list of all cases that meet the following criteria and provide it to the local SCU:

The TA case appears on the IV-D MRB/A Eligible list with Special Alert “Q”;
The pass-through payment issued for the month is equal to $100.00; and
The EXEMPT amount for the month of the support collection is $200.00.

Special Alert “Q” notifies the TA unit that a default pass-through payment was
issued on the TA case in the current month’s IV-D MRB/A process.

The list of cases that meet the criteria described above must be forwarded to the
SCU within five (5) business days of receipt of the IV-D MRB/A Eligible list.
As outlined in Section V(A)(4), the SCU will complete Part A of a Manual Child
Support Pass-Through Payment Determination Worksheet for each case and send
it to the TA unit to complete Part B of the worksheet.

Part B of the Manual Child Support Pass-Through Payment Determination

Worksheet must be completed by the TA worker and all underpayment
adjustments using the Payment Type Code “D1” must be issued within thirty
(30) calendar days of receipt of the worksheet from the SCU. The completed
worksheet must be maintained in the case record.

OTDA 10-ADM-04 20
(Rev. 6/2010)
 10. Resolving Exceptions to the Monthly IV-D MRB/A Process

The IV-D MRB/A Exception list must be reviewed monthly and the appropriate
pass-through payment must be issued for each case that appears on the list. The
TA unit is responsible to resolve all exceptions on the list except those that appear
with IV-D listed as the unit. The exception list does not report Food Stamp
amounts because the Food Stamp portion of the case has not been re-budgeted by
the IV-D MRB/A process. TA units must resolve the exceptions and take
necessary Food Stamp re-budgeting and/or reauthorization actions. All
exceptions must be resolved, appropriate manual authorizations completed,
and pass-through payments issued by the twentieth (20th) calendar day of
each month for support collected in the preceding month.

Note: Amounts listed under the PREV1 and PREV2 fields on the IV-D MRB/A
Exception list must be issued as a separate Payment Type Code “D1” for ROS or
“54” for NYC when resolving the current month’s exceptions.

11. Temporary Assistance Notices, Forms, and Publications

TA units must copy and distribute the revised forms, notices and publications
attached to this ADM where indicated.

a. LDSS-3677 Report of Support Collected

Revisions have been made to the following automated TA notices which

include changes to the pass-through payment amounts as discussed in this
ADM.

LDSS-3677 and LDSS-3677-SP, Report of Support Collected for ROS

local districts (Attachments 3 and 4, respectively); and
LDSS-3677 NYC and LDSS-3677 NYC SP Report of Support
Collected” for NYC (Attachments 5 and 6, respectively).

The revised notices are in production.

b. LDSS-4279 Notice of Responsibilities and Rights for Support

Among the forms revised are the LDSS-4279 and LDSS-4279-SP, Notice
of Responsibilities and Rights for Support (Attachments 7 and 8,
respectively). The LDSS-4279 must be reviewed and completed by all TA
applicants and recipients who are being referred to the SCU. TA units
must inform TA applicants/recipients of their rights, responsibilities and
benefits of their cooperation with the child support enforcement program
by providing the TA applicant/recipient with the LDSS-4279.

The LDSS-4279 must be given to TA applicants and recipients at:

Application;

OTDA 10-ADM-04 21
(Rev. 6/2010)
 When there is a need for a new referral to the child support
enforcement program, such as when a parent left the household, a
pregnancy was verified, or a child joins the household;
Whenever an individual wants to claim good cause; and
At recertification, if there is a change in household composition, or a
recipient wants to claim good cause or no longer wants to claim good
cause.

The TA unit must ask the TA applicant/recipient to indicate on the LDSS-

4279 if he/she does, or does not, claim good cause by checking the
appropriate box. The TA applicant/recipient must sign and date the form.
The TA unit must indicate that they have provided a copy of the form to
the TA applicant/recipient by checking the appropriate box, and signing
and dating the form. A copy of the form must be given to the TA
applicant/recipient and a copy must be maintained in the case record.

c. Changes to Official LDSS-4148 Series Publications

Publications LDSS-4148A, LDSS-4148B, and LDSS-4148D, are three

books provided to TA recipients that provide answers to most questions
about TA, and the related program areas such as Child Support, Foster
Care, Child Welfare, Child Care, and MA. The LDSS-4148A and the
LDSS-4148B provide the recipients with specific information about the
pass-through payment amounts. The LDSS-4148C does not.

12. New TA Unit Responsibilities

a. ROS

1. The TA unit must enter an EXEMPT amount in the ABEL input

screen when using unearned income source codes “06” or code
“13” for TA ABEL budgets calculated as of November 14, 2009 or
later, with a “FROM” date of January 1, 2010, or later.

2. The TA unit is required to maintain and update the appropriate

EXEMPT amount any time new information is presented to them
by the client and/or SCU. The EXEMPT amount will be available
on the IV-D MRB/A Eligible and Exception lists associated with
the IV-D MRB/A process and transmitted to BICS/LDMIP
districts monthly.

3. The EXEMPT amount must be determined at case opening,

recertification, and anytime a change is made to the ABEL budget
or household composition, including changes due to children
turning twenty-one, but remaining in the household. Failure to
maintain the appropriate EXEMPT amount may result in the TA
case receiving an underpayment or overpayment.

OTDA 10-ADM-04 22
(Rev. 6/2010)
 An underpayment adjustment must be issued when the incorrect
EXEMPT amount is stored in the TA ABEL budget and results in
the TA household not receiving the maximum pass-through
payment or disregard amount. The underpayment must be issued
within thirty (30) calendar days of discovery of the underpayment.

If failure to maintain the appropriate EXEMPT amount results in

an overpayment, the overpayment must be established and
recoupment must begin.

4. The TA unit must enter spousal support income in the TA ABEL

budget as unearned income source code “02.”

5. The TA unit must enter child support and combined child and
spousal support as income source code “06” or code “13,” where
appropriate.

6. The TA unit must not adjust any pass-through payments which are
issued as a result of the IV-D MRB/A process and are listed on the
IV-D MRB/A Eligible list.

7. Upon receipt of a Manual Child Support Pass-Through Payment

Determination Worksheet from the SCU, the TA unit must
complete Part B of the worksheet and all necessary underpayment
adjustments or establishment of overpayments must be completed
as described in Section IV(C) above.

8. The TA unit is required to forward a list of cases that appear on the

IV-D MRB/A Eligible list and meet the criteria described in Section
V(B)(9) above with a Special Alert “Q“ to the SCU to initiate a
Manual Child Support Pass-Through Payment Determination
Worksheet (Attachment 1) within five (5) business days of receipt
of the IV-D MRB/A Eligible list. After the SCU completes Part A
and submits the worksheet to the TA unit, the TA unit must
complete Part B of the worksheet and must issue all necessary
underpayment adjustments using Payment Type Code “D1” within
thirty (30) calendar days of receipt of the worksheet from the SCU.

If any overpayments exist, overpayments must be established

within thirty (30) calendar days of receipt of the worksheet from
the SCU.

9. The TA unit continues to be required to update the unearned

income source code “13” any time new information is presented to
them by the client and/or SCU. The assigned support amount used
for the current month’s IV-D MRB/A process will be available on
the IV-D MRB/A Eligible and Exception lists associated with the
monthly IV-D MRB/A process and transmitted to BICS/LDMIP
districts monthly. In addition, the IV-D MRB/A Eligible and
OTDA 10-ADM-04 23
(Rev. 6/2010)
 Exception lists are available through the IV-D Inquiry selection on
the ABEL menu on WMS. For more information refer to ABEL
Transmittal 09-3, Information #3.

b. NYC

NYC HRA must enter spousal support in the TA budget as unearned

income source code “68.”

There are no other new worker responsibilities for NYC HRA staff.

C. Temporary Assistance Work Activities

TA units are reminded that changes in the household’s TA or Food Stamp benefits may
require an adjustment in the maximum number of hours that an individual may be
assigned to work experience. The maximum number of hours that an individual may be
assigned to work experience is limited to the participant’s combined TA budget deficit
and Food Stamp allotment, if any, divided by the greater of the Federal or State minimum
wage. However, in no instance may an individual be required to participate in work
experience or other work activities for more than forty (40) hours per week.

TA units must evaluate changes in the household’s TA or Food Stamp benefits, such as a
decrease in the Food Stamp allotment which may occur as a result of an increase in the
child support pass-through payment, to determine if an adjustment in the number of hours
that an individual may be assigned to work experience is necessary and make any
necessary adjustments in a timely manner.

D. Desk Reviews

1. Desk Review Pass-through Amounts

SCUs and TA units must consider pass-through increases, effective January 1,

2010, when performing a desk review. A desk review is limited to an accounting
of the collections and disbursements made during the calendar year in which the
desk review is requested and the calendar year preceding the calendar year in
which the desk review is requested. As such, TA units must consider the
following when determining the appropriate pass-through payment amount(s) a
TA recipient or former-recipient is entitled to:

the first $100.00 of current support collected per month for families with one
individual under the age of twenty-one, and up to the first $200.00 of current
support collected per month for families with two or more individuals under
the age of twenty-one January 1, 2010 and after;
the first $100.00 pass-through payment for current support collections made in
October, 2008 through December 31, 2009; and
An amount up to a $50.00 pass-through payment for current support
collections for periods before October 1, 2008.

OTDA 10-ADM-04 24
(Rev. 6/2010)
 Revisions to the desk review process, including changes to the pass-through
payment amount, will be issued through a separate ADM. SCUs and TA units
must continue to follow the procedures outlined in 06-ADM-16, dated December
16, 2006, and entitled Desk Reviews of the Distribution of Child Support
Payments, and to use the related pass-through payment and cumulative excess
support worksheets and instructions provided with 08-ADM-08. Additionally,
SCUs and TA units must continue to use the revised forms, notices, excess
current support worksheets and instructions with 09-ADM-21, dated November
13, 2009, and entitled Temporary Assistance Excess Support Process and
Procedures for Reviewing Cases that have Support Collections in Excess of the
Temporary Assistance Deficit, until further notice.

2. Desk Review Process and Forms

The changes to the pass-through payment amount require revisions to the desk
review forms, calculation worksheets, worksheet instructions, and determination
letters effective January 1, 2010. Revisions to these documents incorporating the
changes to the pass-through payment dollar amounts discussed in this ADM, as
well as additional changes to the desk review process, will be forthcoming in a
separate ADM. Those revisions include:

Improvements to the desk review process provided for in 06-ADM-16,

including new letters for issues outside of the desk review process;
Changes to the desk review forms, calculation worksheets, worksheet
instructions, and the second-level determination letter provided in 08-ADM-
08; and
Incorporation of the changes to the desk review process for excess support,
including the desk review request form and instructions, Calculations
Worksheet Desk Review of Excess Current Support and instructions, and the
first-level determination letter as provided in 09-ADM-21.

E. Child Support Forms and Website

1. Changes to OTDA Official Notices

As discussed in 10-ADM-01, and currently in use at local districts, revisions were

made to the LDSS-3908 and LDSS-3908-SP, Important Notice Regarding Child
Support to Persons Applying for or Receiving Temporary Assistance or Foster
Care Maintenance Payments Under Title IV-E (Attachments 9 and 10,
respectively), effective October 1, 2009, which included the changes to the pass-
through payment amounts discussed in this ADM.

2. New York State Child Support Website

Information provided to the custodial and noncustodial parents on the New York
State Child Support Website (newyorkchildsupport.com) has been revised to
include the changes to the pass-through payment amounts discussed in this ADM.

OTDA 10-ADM-04 25
(Rev. 6/2010)
 F. Ordering and Availability of Forms and Publications

1. Ordering of LDSS Forms through OTDA

a. OTDA-876 Process

SCUs and TA units must request printed copies of the revised LDSS forms
by completing and submitting an OTDA-876, Request for Forms or
Publications, to:

Office of Temporary and Disability Assistance

BMS Document Services and Operational Support
P.O. Box 1990
Albany, New York 12201

Questions concerning ordering forms should be directed to BMS

Document Services at 1-800-343-8859, ext. 4-9522.

b. OTDA Intranet Website

Documents may also be ordered through Outlook. To order the forms you
must obtain and complete an OTDA-876 form electronically by going to
the OTDA Intranet Website at: http://otda.state.nyenet/, then to Division
of Operations and Program Support page and then to OPS E-Forms page,
Bureau of Management Services section (this section contains the
electronic OTDA-876). The completed OTDA-876 form may be e-mailed
to: gg7359@otda.state.ny.us.

For a complete list of forms available for downloading, please refer to

OTDA Intranet site: http://otda.state.nyenet/ldss_eforms/default.htm.

c. Via E-mail

For those who do not have Outlook but who have Internet access for
sending and receiving e-mail, the Internet email address is:
gg7359@otda.state.ny.us.

VI. Systems Implications

A. Child Support Enforcement

Several modifications have been made to the monthly pass-through/disregard process and
CSMS to support the pass-through/disregard changes for both ROS and NYC. Effective
with the January 29, 2010 CSMS month end processing, CSMS will no longer calculate
the amount of the pass-through payment. Instead, TA is required to determine the
amount of the pass-through payment and disregard that a family is entitled to under the
statutory changes. As such, the following changes have been made to CSMS:

OTDA 10-ADM-04 26
(Rev. 6/2010)
 1. Revisions to the Monthly Disregard Process

CSMS is no longer calculating a disregard amount based on the DUE, APPLIED

and a $100.00 cap. Instead, effective with the January 31, 2010, CSMS monthly
disregard file, CSMS will provide WMS with four new collection fields, as
follows. These fields will include the total amount for all accounts associated
with the TA-CAN:

a. Total paid for Disregard month: This field provides the total of all
payments (Batch types 50, 51, 52, 53, 54, 56, 57, 58 and 70’s) received in
the current month unless there is a 79 UNAP transaction from the prior
month greater than 0. If there is a 79 UNAP transaction from the prior
month greater than 0, then the sum of all current month 79 APP
transactions (less any Batch types 55 or +75) applied to all disregard
eligible ledgers plus any payments received after the CSMS month end
accounting run through the calendar end of month is used. This field is
not stored on the CSMS IVDHTM record (History of Monetary
Transactions Screen) with a 98 DSGD transaction (see Section VI(A)(2)
below).

b. Prior month’s payments: This field provides the total of all payments
received in the current month that were receipted in the prior month (Prior
month). Those payments include CSMS batch types 50, 51, 52, 53, 54,
56, 57, 58, 71, 72, 74, and 77. This value is stored on the IVDHTM
record with a 97 PDSG transaction (see Section VI(A)(2) below). The
transaction date is the Prior month’s disregard process date, while FIELD
1 represents the current disregard month. The total of Prior month’s
payments is stored in FIELD 2.

c. 2nd Prior month’s payments: This field provides the total of all payments
received in the current month that were receipted in the month preceding
the prior month (2nd Prior month). Those payments include CSMS batch
types 50, 51, 52, 53, 54, 56, 57, 58, 71, 72, 74, and 77. This value is
stored on the IVDHTM record with a 97 PDSG transaction (see Section
VI(A)(2) below). The transaction date is the 2nd Prior month’s disregard
process date, while FIELD 1 represents the current disregard month. The
total of 2nd Prior month’s payments is stored in FIELD 2.

d. Current month’s collections: This field provides the difference between

the total paid for Disregard month in Section VI(A)(1)(a) above and the
sum of the Prior month’s payments in Section VI(A)(1)(b) above and the
2nd Prior month’s payments in Section VI(A)(1)(c) above. This value is
stored on the IVDHTM record with a 98 DSGD transaction (see Section
VI(A)(2) below). The transaction date is the current month disregard
process date. FIELD 1 is blank and FIELD 2 is the total current month’s
collections.

Note: In order to be eligible for a pass-through payment, an account must have

an eligible ledger, which include: 21A---, 23A---, 21BP--, 23BP--, 21BR--,
OTDA 10-ADM-04 27
(Rev. 6/2010)
 23BR--, 21CA--, 23CA--, 21CP--, 23CP--, 21CR--, and 23CR--. Additionally, an
account must have a CASE STAT on the CSMS IVDJCA record equal to “1”
(Active TANF or IV-E); “7” (Active Safety Net; never TANF/IV-E); “8” (Active
Safety Net; former TANF/IV-E); or “0” (Former TANF/IV-E); “4” (Active MA
only; never TANF/IV-E), “6” (Active MA only; former TANF/IV-E), or “9”
(Former MA; never TANF/IV-E), when the CASE STAT becomes either “0,” “4,”
“6,” or “9” in the current pass-through payment processing month.

2. CSMS IVDHTM Screen Changes

Below is an example of the IVDHTM record reflecting the money transactions for
the new disregard process. The disregard month is March 2010. There is a 2nd
Prior month receipted payment for January 2010, a Prior month receipted
payment for February 2010, and a Current month receipted payment for March
2010 .

-IVDHST AB12345C1 ALBANY COUNTY* ASCU MONETARY * 04/01/10 10:26:56

RESP: DOE, JOHN CLI: DOE, JANE #TRANS 005
TC TYPE DATE BATCH PAID DUE APPL DISB FIELD1 FIELD2
69 DUE 02 26 10 252.00 21AW 686.00
98 DSGD 02 28 10 0.00
PYMT 012710 0301A04 150.00
PYMT 022510 0301A09 150.00
PYMT 031710 0317A01 200.00
79APP 032610 500.00
69 DUE 03 2610 252.00 21AW 436.00
97 PDSG 013110 03/10 150.00
97 PDSG 022810 03/10 150.00
98 DSGD 033110 200.00

KEY ____________________________PAGE 001 OF 001 XMT/PASSOFF -> ____ <-

3. Change in Disregard Informational Lists Reports

a. Discontinued Disregard Reporting Sections

As discussed in the “Dear Colleague” Letters dated June 15, 1990, August
6, 1992, and October 26, 1993, CSMS currently produces the Disregard
Informational Lists report that was sent to BICS and stored on COLD.
The report included five sections. Effective with the January 29, 2010
CSMS month end processing, the following four sections of the report
were discontinued:

$100 Disregard-Disregard Applied Greater than Ledger Applied;

$100 Disregard-S25 Accounts;
$100 Disregard-Greater than Current Month Applied; and
$100 Disregard-Accounts with Aged Payments.

OTDA 10-ADM-04 28
(Rev. 6/2010)
 b. Continuation of Negative 71 or 72 Payments Section

One section of the report will remain as the Disregard Informational List:

$100 Disregard-Accounts with Negative 71 or 72 Payments.

The report is produced monthly following the CSMS disregard processing.

The list will continue to be sorted in alphabetical order by custodial parent
name and will include the CSMS account number, the TA-CAN, the
custodial parent CIN, and the custodial parent’s social security number.
The monthly report is stored on COLD. The COLD report name is
DISREGARDINFLISTS.

B. Temporary Assistance and Food Stamp WMS

1. ROS

Beginning with the February 2010 IV-D MRB/A process, ROS systems will
automatically update the Monthly Obligation and EXEMPT amounts on ABEL
at each month’s IV-D MRB/A process based off of the most recent information
available at the time of the IV-D MRB/A process. The Monthly Obligation
(unearned income source code “13”) will be updated from the current amount
available from the CSMS file. The EXEMPT amount will be updated based off
of the current case information available in WMS at the time of the IV-D MRB/A
process.

2. NYC

Effective February 2010 for January child support collections listed in the
monthly CSMS disregard file, WMS ABEL programmers will utilize the newly
established child criteria to determine the number of eligible children for each
household then pass through either $100.00 maximum for one child, or a
maximum of $200.00 for households with two or more qualifying children. The
amount to be issued will be based either on the monthly support obligation, the
amount collected or the $100.00/$200.00 maximum based on household size. A
single issue transaction will be generated to issue the benefits to the household via
the Electronic Benefits Transfer (EBT), and the cases will be budgeted
prospectively to apply the amount allocated (up to the maximum) to the Food
Stamp budget.

Effective February 2010 (02/A/2010), WMS will also be updated to automatically

disregard up to $100.00 or $200.00 per household for combined child and spousal
support (income source codes “14” and “61”).

CSMS collection and obligation information as identified on the CSMS disregard

file will be forwarded to NYC HRA via a secure server for manual budgeting.
For households in receipt of Family Arrears income for two or more successive
months, the amounts will be averaged and budgeted as recurring income.

OTDA 10-ADM-04 29
(Rev. 6/2010)
VII. Additional Information (Optional)

Fiscal Claiming Instructions

Please refer to the Fiscal Reference Manual (FRM), Volume 2, Chapter 3, for pass-through and
disregard payment claiming instructions. The February 2010 update to the FRM reflects the
change to the pass-through and disregard amounts.

VIII. Effective Date

This ADM, providing for changes to the pass-through and disregard process, and the revised
documents implementing those changes attached hereto, are effective immediately. For the child
support enforcement program, the system changes for determining the pass-through payments
became effective with the January 29, 2010 CSMS month end processing. For the TA program,
the issuance of the pass-through payment and disregard amounts as revised under Phase II of the
legislative changes became effective with the February 2010 monthly IV-D MRB/A process.

Issued By
Name: Scott E. Cade
Title: Deputy Commissioner and Director
Division/Office: Center for Child Well-Being
Division of Child Support Enforcement

Issued By
Name: Russell Sykes
Title: Deputy Commissioner
Division/Office: Center for Employment and Economic Supports

OTDA 10-ADM-04 30
(Rev. 6/2010)
 MANUAL CHILD SUPPORT PASS-THROUGH PAYMENT DETERMINATION WORKSHEET

County Name:_______________________

Source of Pass-through Payment Review:

Disregard Informational list MRB/A IV-D Exception list TA Unit Request Other_____________

PART A: TO BE COMPLETED BY SUPPORT COLLECTION UNIT (SCU)

Temporary Assistance TA Case
(TA) Recipient/ Custodial Number CSMS New York Case Pass-Through Payment Period
Parent Name (TA-CAN) Identifier(s) for TA-CAN to be Reviewed
From To

Month/Year Month/Year Month/Year

1. Total monthly current support obligation(s)

Total collected and disbursed to DSS for current
2.
support
SCU Worker Name Title Telephone Number Date

PART B: TO BE COMPLETED BY THE SOCIAL SERVICES DISTRICT’S (SSD’S) TA UNIT

Month/Year Month/Year Month/Year

Compare line 1 to line 2 in Part A above and enter

1.
the lesser amount
Enter the number of individuals under the age of 21
2. active on the TA case at the end of the month or at
the time of TA case closure for closed cases
If the result of line 2 of Part B is:
zero, enter zero
3.
one, enter 100.00
two or more, enter 200.00
Compare line 1 to line 3 of Part B and enter the
4.
lesser amount
Enter the amount of the pass-through payment
5.
previously issued, if any
Subtract line 5 from line 4. If the amount is positive,
this is the amount of pass-through payment(s) due to
the TA case that must be issued. If the amount is
6. negative, this is the amount of the overpayment that
the TA case received. If zero, than there is no pass-
through payment to be issued or overpayment
received.
TA Unit Worker Name Date
 DIRECTIONS FOR THE MANUAL CHILD SUPPORT PASS-THROUGH PAYMENT DETERMINATION WORKSHEET

The Manual Child Support Pass-Through Payment Determination Worksheet must be used when a determination of a pass-
through (P/T) payment must be made manually. The Support Collection Unit (SCU) would initiate a manual determination of
P/T payment by completing Part A if (1) the TA case appears where an adjustment to a CSMS account affects the amount of
a P/T payment; (2) a case appears on the IV-D MRB/A Exception list for the IV-D Unit and it is determined that a P/T payment
should be issued; (3) the SSD's TA unit identifies a case which requires review for a P/T payment; or (4) any other reason that
a P/T payment manual determination is necessary. The SCU must enter the county name; identify the source of the P/T
payment review request, and complete Part A; the Social Services District’s (SSD’s) Temporary Assistance (TA) unit must
complete Part B. The completed worksheet must be kept in the TA case record.

PART A - To be completed by the SCU:

The SCU initiating the manual determination must include the identifying information for the review, including the TA case
(TA-CAN); CSMS New York Case Identifier(s) associated with the TA-CAN, and the period of the review for P/T payments.
Additionally, the SCU must provide information from CSMS which will assist the SSD’s TA unit in determining the appropriate
amount of P/T payment.

Line 1 - Enter the total monthly current support obligation(s). The SCU must identify all P/T eligible ledgers for each CSMS
account with the same TA-CAN (and suffix for NYC), including: 21A_, 23A_, 21BP, 23BP, 21BR, 23BR, 21CP, 23CP, 21CR,
23CR, 21CA, and 23CA, with a retained FIPS code. The SCU must sum the obligations and factor that amount to a monthly
obligation. To factor to a monthly obligation, where the OBLIG-FREQ field on the individual ledger of the IVDQRY record is:
Weekly (D07) multiply x 4.33333; Bi-weekly (D14) multiply x 2.16667; Semi-Monthly (B) multiply x 2.0; Monthly (M) multiply x
1.0; Quarterly (Q) multiply x .33333; Semi-annually (S) multiply x .16667; and Annually (A) multiply x .08333.

Line 2 – Enter the total collected and disbursed to DSS as current support for the month. The SCU must review the IVDHTM
record or account tab, MONEY screen, on ASSETS for each CSMS account with the same TA-CAN (and suffix for NYC).
Current support is support that is paid and systematically applied to a charging P/T eligible ledger (see Line 1 above) with a
retained FIPS code. SCU workers can determine if there are active charging current support ledgers as identified above by
reviewing the CSMS IVDQFS record and checking the first and last charge dates with an obligation amount greater than zero
and a ledger status of “01” (active). Current collections would include CSMS batch types 50, 53, 54, 56, 57, and positive batch
71, 72, 74, and 77 transactions for the month in question. Current support does not include collections applied to arrears
ledgers by Federal income tax refund offset, or payments that were applied to any other arrears ledgers. The SCU worker
who completes Part A must sign, and enter their title, telephone number, and the date that Part A is completed; and submit
the form to the SSD’s TA unit.

PART B: To be completed by the SSD’s TA Unit

The SSD’s TA unit must complete the review for determining the appropriate amount of P/T payment by completing Part B:

Line 1 – Compare line 1 to line 2 in Part B and enter the lesser amount. This is used to determine the maximum amount of
P/T to which the TA case may be entitled.

Line 2 – Enter the number of individuals under the age of 21 who are active on the TA case at the end of the month or at the
time of TA case closure for closed cases. This is used to determine the maximum amount of P/T to which the TA case may
be entitled.

Line 3 – If Line 2 of Part B is: zero, enter zero; one, enter 100.00; two or more, enter 200.00. This is the maximum amount of
P/T to which the TA case may be entitled.

Line 4 – Compare line 1 to line 3 in Part B and enter the lesser amount. This is the maximum amount of P/T to which the TA
case may be entitled.

Line 5 - Enter the amount of the P/T payment previously issued, if any. Any P/T received for the review month must be
assessed to determine if an overpayment or underpayment occurred.

Line 6 - Subtract line 5 from line 4 and enter any underpayment or overpayment amount(s) for each month of the P/T review
period. The underpayment amount(s) is the amount of the P/T that must be issued to the TA case. The overpayment
amount(s) is the amount of the P/T that the TA case received that must be used to establish an underpayment. If zero, than
there is no pass-through payment to be issued or overpayment received.

The SSD’s TA unit worker who completes Part B must sign and enter the date that Part B is completed.
 Examples for Determining the Amount of Pass-Through/Disregard
Provided to Temporary Assistance Families Effective January 1, 2010

The statutory provisions of Social Services Law §§ 111-c(2)(d) and 131-a(8)(a)(v) as amended provide that the pass-through payment and/or
disregard will continue in an amount of up to $100 per month for a IV-A household(*) with one child(**) and increases to an amount of up to
$200 per month for a IV-A household(*) with two or more children(**), effective January 1, 2010. (*) Household is defined for support pass-
through payment and disregard purposes as the TA case (TA-CAN). The phrase "family in receipt of temporary assistance" shall also be
synonymous with the TA-CAN for the child support pass-through and disregard purposes. (**) Child is defined for support pass-through
payment and disregard purposes to be all individuals under the age of 21 who are active individual members of the TA-CAN, including those
individuals subject to a pro rata or IV-D sanction.

IV-A Payment Type Codes D1 (IV-D Payment) for Rest of State, and 54 (Child Support Bonus Payment - Manual Issuance) and 70 (Child
Support Bonus Payment) for New York City, provide a pass-through payment and exempt amount in the TA budget where there is a child
support or combined child and spousal support order payable through a Support Collection Unit. IV-A Payment Type Code 18 (Child Support
Disregard) for Rest of State provides a disregard and exempt amount in the TA budget where there is a child support or combined child and
spousal support order payable directly to the family. Where there is an order for spousal support only, individuals will not receive any
exemptions on spousal support income. Spousal support for an individual may only be considered for purposes of determining the appropriate
pass-through payment and exempt amount when the spousal support is part of a combined child and spousal support order payable through the
Support Collection Unit and there is a child as defined above active on the TA case.

Collections Pass-Through
For SSDs: For SCUs: Current for Non- Amount
Support Collections IV-D Determined for the
for IV-D Order of Order for Family IV-A
Support (either Spousal Amount Entered (IV-A Payment Disregard
Order for Payable through the Support in ABEL Input Type Codes D1 for Payment
IV-A Case Support Support Collection or Screen for the Rest of State, or 54 Type Code 18
Family and CSMS Unit or a Direct Pay Voluntary EXEMPT or 70 for New York for Rest of
Example Members Account Order) Collections FIELD City) State Only Summary
1 Mother (age There is one $250 is collected on N/A $100 $100 $0 There is one TA
23) and one order of support the CSMS account. case number (TA-
child under payable through CAN) and one child
the age of 21. the Support under the age of 21
Collection Unit on the TA-CAN.
(SCU) and one
CSMS account. The household is
entitled to a $100
pass-through.

1
 Collections Pass-Through
For SSDs: For SCUs: Current for Non- Amount
Support Collections IV-D Determined for the
for IV-D Order of Order for Family IV-A
Support (either Spousal Amount Entered (IV-A Payment Disregard
Order for Payable through the Support in ABEL Input Type Codes D1 for Payment
IV-A Case Support Support Collection or Screen for the Rest of State, or 54 Type Code 18
Family and CSMS Unit or a Direct Pay Voluntary EXEMPT or 70 for New York for Rest of
Example Members Account Order) Collections FIELD City) State Only Summary
2 Mother (age There are two $250 is collected on N/A $200 $200 $0 There is one TA-
28) and two orders for support the CSMS account CAN and two
children payable through for child one. children under the
under the age the SCU and two age of 21 on the TA-
of 21. CSMS accounts $0 is collected for CAN.
for each absent the CSMS account
The children parent/ for child two. The household is
have different noncustodial entitled to a $200
absent parent (NCP) and pass-through.
parents. child.
3 Mother (age There are two $100 is collected on N/A $125 $125 $0 There is one TA-
28) and two orders of support the CSMS account CAN and two
children payable through for child one. children under the
under the age the SCU and two age of 21 on the TA-
of 21. CSMS accounts $25 is collected for CAN.
for each NCP and the CSMS account
The children child. for child two. Although the
have different household would be
absent eligible for a pass-
parents. through of up to
$200 for two
children under the
age of 21, the pass-
through is limited by
the amount collected
of $125.
4 Mother (age There is one $200 is collected on N/A $200 $200 $0 There is one TA-
28) and two order of support the CSMS account CAN and two
children payable through for child one. children under the
under the age the SCU and one age of 21 on the TA-
of 21. CSMS account CAN.
for the first NCP
2
 Collections Pass-Through
For SSDs: For SCUs: Current for Non- Amount
Support Collections IV-D Determined for the
for IV-D Order of Order for Family IV-A
Support (either Spousal Amount Entered (IV-A Payment Disregard
Order for Payable through the Support in ABEL Input Type Codes D1 for Payment
IV-A Case Support Support Collection or Screen for the Rest of State, or 54 Type Code 18
Family and CSMS Unit or a Direct Pay Voluntary EXEMPT or 70 for New York for Rest of
Example Members Account Order) Collections FIELD City) State Only Summary
The children and child. The household is
have different entitled to a $200
absent No order of pass-through.
parents. support or CSMS
account has been
established for
the second NCP
and child.
5 Mother (age No order of N/A $250 is $200 $0 $200 There is one TA-
28) and two support or CSMS paid CAN and two
children account has been directly to children under the
under the age established for the family age of 21 on the TA-
of 21. the children. for CAN.
support of
The children the The household is not
have the children. entitled to a pass-
same absent through because
parent. there is no order of
support payable
through the Support
Collection Unit.
The $250 collection
is considered in
determining the
grant amount, for
which the household
is entitled to a $200
exempt amount from
the budget. $50
would be budgeted.
6 Mother There are three $0 is collected on N/A $200 $200 $0 There is one TA-
(under the orders of support the CSMS account CAN and two
3
 Collections Pass-Through
For SSDs: For SCUs: Current for Non- Amount
Support Collections IV-D Determined for the
for IV-D Order of Order for Family IV-A
Support (either Spousal Amount Entered (IV-A Payment Disregard
Order for Payable through the Support in ABEL Input Type Codes D1 for Payment
IV-A Case Support Support Collection or Screen for the Rest of State, or 54 Type Code 18
Family and CSMS Unit or a Direct Pay Voluntary EXEMPT or 70 for New York for Rest of
Example Members Account Order) Collections FIELD City) State Only Summary
age of 21) payable through for parent 1 of the children under the
and her one the SCU; one for underage mother. age of 21 (including
child under each NCP of the underage mother) on
the age of 21. underage mother $0 is collected on the TA-CAN.
and one for the the CSMS account
There are two NCP of her for parent 2 of the The household is
absent child), and three underage mother. entitled to a $200
parents for CSMS accounts. pass-through.
the underage $250 is collected on
mother and the CSMS account
one absent for her child.
parent for her
child.
7 Mother and There is no order $250 is collected on N/A $200 $200 $0 There is one TA-
father (ages 27 of support or the CSMS account. CAN and two
and 28, CSMS account children under the
respectively) for the intact age of 21 on the TA-
and their one family. CAN.
child under the
age of 21. There is one The household is
order of support entitled to a $200
Mother has payable through pass-through.
second child the SCU and
under the age CSMS account
of 21 with an for the NCP of
absent parent. the mother’s
second child.
8 Mother There is one $250 is collected on N/A $200 $200 $0 There is one TA-
(under the order of support the CSMS account. CAN and two
age of 21) payable through children under the
and her one the SCU and one age of 21 (including
child under CSMS account underage mother) on
4
 Collections Pass-Through
For SSDs: For SCUs: Current for Non- Amount
Support Collections IV-D Determined for the
for IV-D Order of Order for Family IV-A
Support (either Spousal Amount Entered (IV-A Payment Disregard
Order for Payable through the Support in ABEL Input Type Codes D1 for Payment
IV-A Case Support Support Collection or Screen for the Rest of State, or 54 Type Code 18
Family and CSMS Unit or a Direct Pay Voluntary EXEMPT or 70 for New York for Rest of
Example Members Account Order) Collections FIELD City) State Only Summary
the age of 21. for the NCP of the TA-CAN.
the underage
There is one mother. Although the mother
absent parent is subject to a pro
for the No order of rata employment
underage support or CSMS sanction, the case is
mother and account has been still considered
one absent established for active TA.
parent for her the underage
child. mother’s child. Therefore, the
household is entitled
The mother is to a $200 pass-
subject to a through.
pro rata
employment
sanction.

9 Mother There is one $250 is collected on N/A $100 $0 $100 There is one TA-
(under the order of support the CSMS account. CAN and two
age of 21) payable through children under the
and her one the SCU and one age of 21 (including
child under CSMS account the underage
the age of 21. for the NCP of mother) on the TA-
the underage CAN.
There is one mother.
absent parent: However, because
for the No order of the mother is subject
underage support or CSMS to an incremental
mother and account has been sanction, the
one absent established for sanctioned mother is
parent for her the underage considered inactive
child. mother’s child. on the case for the
5
 Collections Pass-Through
For SSDs: For SCUs: Current for Non- Amount
Support Collections IV-D Determined for the
for IV-D Order of Order for Family IV-A
Support (either Spousal Amount Entered (IV-A Payment Disregard
Order for Payable through the Support in ABEL Input Type Codes D1 for Payment
IV-A Case Support Support Collection or Screen for the Rest of State, or 54 Type Code 18
Family and CSMS Unit or a Direct Pay Voluntary EXEMPT or 70 for New York for Rest of
Example Members Account Order) Collections FIELD City) State Only Summary
period of the
The mother is sanction, and
subject to an therefore not
incremental included in the
sanction. calculation of the
pass-through.

The household is
also not entitled to a
pass-through
because there is no
order of support
payable through the
Support Collection
Unit for the child
who is active on the
case (and included
in the calculation).
The $250 collection
is considered in
determining the
grant amount, for
which the household
is entitled to a $100
exempt amount from
the budget. $150
would be budgeted.
10 Mother There is one $0 is collected on N/A $100 $100 $0 There is one TA-
(under the order of support the CSMS account CAN and two
age of 21) payable through for the underage children under the
and her one the SCU and one mother. age of 21 (including
child under CSMS account the underage

6
 Collections Pass-Through
For SSDs: For SCUs: Current for Non- Amount
Support Collections IV-D Determined for the
for IV-D Order of Order for Family IV-A
Support (either Spousal Amount Entered (IV-A Payment Disregard
Order for Payable through the Support in ABEL Input Type Codes D1 for Payment
IV-A Case Support Support Collection or Screen for the Rest of State, or 54 Type Code 18
Family and CSMS Unit or a Direct Pay Voluntary EXEMPT or 70 for New York for Rest of
Example Members Account Order) Collections FIELD City) State Only Summary
the age of 21. for the NCP of $250 is collected on mother) on the TA-
the underage the CSMS account CAN.
There is one mother. for her child.
absent parent: However, because
for the There is one the mother is subject
underage order of support to an incremental
mother and payable through sanction, the
one absent the SCU and one sanctioned mother is
parent for her CSMS account considered inactive
child. for the underage on the case for the
mother’s child. period of the
The mother is sanction, and
subject to an therefore not
incremental included in the
sanction. calculation of the
pass-through.

Therefore, the
household is entitled
to a $100 pass-
through for the
underage mother’s
child.
11 Mother (age There is one $250 is collected on N/A $100 (TA-CAN 1) $100 (TA-CAN 1) $0 There are two TA-
28) and her order of support the CSMS account. $ 0 (TA-CAN 2) $ 0 (TA-CAN 2) CANs. TA-CAN
two children for the two $100 TOTAL $100 TOTAL number 1 has one
under the age children payable child under the age
of 21. through the SCU of 21; and TA-CAN
and one CSMS number 2 has one
One child account. child under 21 (the
turns 18 and 18 year old).
has opted for Although the one
7
 Collections Pass-Through
For SSDs: For SCUs: Current for Non- Amount
Support Collections IV-D Determined for the
for IV-D Order of Order for Family IV-A
Support (either Spousal Amount Entered (IV-A Payment Disregard
Order for Payable through the Support in ABEL Input Type Codes D1 for Payment
IV-A Case Support Support Collection or Screen for the Rest of State, or 54 Type Code 18
Family and CSMS Unit or a Direct Pay Voluntary EXEMPT or 70 for New York for Rest of
Example Members Account Order) Collections FIELD City) State Only Summary
his own TA child has opted Because there are
case. for his own TA two TA-CANs, the
case, no separate review for the pass-
order of support through must be
or CSMS account conducted separately
has been for each TA-CAN.
established for
that child. Under TA-CAN
number 1, $250 has
been collected, and
since the TA-CAN
has one child under
the age of 21, the
household is entitled
to a $100 pass-
through.

Under TA-CAN
number 2, nothing
has been collected
and therefore the
household would not
be entitled to a pass-
through for this
case.
12 Mother (age There is one $150 is collected on N/A $150 (TA-CAN 1) $150 (TA-CAN 1) $0 There are two TA-
34) and her allocated order of the first CSMS $100 (TA-CAN 2) $100 (TA-CAN 2) CANs. TA-CAN
three children support payable account. $250 TOTAL $250 TOTAL number 1 has two
under the age through the SCU children under the
of 21. and two CSMS $100 is collected on age of 21, and TA-
accounts for the the second CSMS CAN number 2 has
One child three children; account. one child under the
8
 Collections Pass-Through
For SSDs: For SCUs: Current for Non- Amount
Support Collections IV-D Determined for the
for IV-D Order of Order for Family IV-A
Support (either Spousal Amount Entered (IV-A Payment Disregard
Order for Payable through the Support in ABEL Input Type Codes D1 for Payment
IV-A Case Support Support Collection or Screen for the Rest of State, or 54 Type Code 18
Family and CSMS Unit or a Direct Pay Voluntary EXEMPT or 70 for New York for Rest of
Example Members Account Order) Collections FIELD City) State Only Summary
turns 18 and one CSMS age of 21 (the 18
has opted for account for two year old).
her own TA of the children
case (reflecting the Because there are
60% allocation in two TA-CANs, the
the court order review for the pass-
for these through must be
children), and a conducted separately
second CSMS for each TA-CAN.
account for the Under TA-CAN
18 year old child number 1, $150 has
(reflecting the been collected, and
40% allocation in since the TA-CAN
the court order has two children
for this child). under the age of 21,
the household is
entitled to a $150
pass-through for that
TA-CAN (limited
by the amount of the
collection).

Under TA-CAN
number 2, $100 has
been collected, and
since the TA-CAN
has one child under
the age of 21 (the 18
year old), the
household is entitled
to a $100 pass-
through for that TA-
9
 Collections Pass-Through
For SSDs: For SCUs: Current for Non- Amount
Support Collections IV-D Determined for the
for IV-D Order of Order for Family IV-A
Support (either Spousal Amount Entered (IV-A Payment Disregard
Order for Payable through the Support in ABEL Input Type Codes D1 for Payment
IV-A Case Support Support Collection or Screen for the Rest of State, or 54 Type Code 18
Family and CSMS Unit or a Direct Pay Voluntary EXEMPT or 70 for New York for Rest of
Example Members Account Order) Collections FIELD City) State Only Summary
CAN.
13 Mother (age There is one $250 is collected on N/A $200 $200 $0 There is one TA-
26) and her order of support the CSMS account. CAN and two
two children payable through children under the
under the age the SCU and one age of 21 on the TA-
of 21. CSMS account CAN.
for the two
One child children. The household is
turns age 18, entitled to a $200
and continues pass-through.
on the TA
case as an
“essential
person.”

14 Mother (age There is one $250 is collected on N/A $100 (TA-CAN 1) $100 (TA-CAN 1) $0 There are two TA-
36) and her order of support the CSMS account. $ 0 (TA-CAN 2) $ 0 (TA-CAN 2) CANs (Safety Net
two children payable through $100 TOTAL $100 TOTAL Assistance). TA-
under the age the SCU and one CAN number 1 has
of 21 on CSMS account one child under the
Safety Net for the two age of 21; and TA-
Assistance. children. CAN number 2 has
one child under 21
One child Although the one (the 18 year old).
turns 18 and child has opted

10
 Collections Pass-Through
For SSDs: For SCUs: Current for Non- Amount
Support Collections IV-D Determined for the
for IV-D Order of Order for Family IV-A
Support (either Spousal Amount Entered (IV-A Payment Disregard
Order for Payable through the Support in ABEL Input Type Codes D1 for Payment
IV-A Case Support Support Collection or Screen for the Rest of State, or 54 Type Code 18
Family and CSMS Unit or a Direct Pay Voluntary EXEMPT or 70 for New York for Rest of
Example Members Account Order) Collections FIELD City) State Only Summary
has opted for for his own TA Because there are
her own TA case, no separate two TA-CANs, the
case order of support review for the pass-
or CSMS account through must be
has been conducted separately
established for for each TA-CAN.
that child.
Under TA-CAN
number 1, $250 has
been collected, and
since the TA-CAN
has one child under
the age of 21, the
household is entitled
to a $100 pass-
through.

Under TA-CAN
number 2, nothing
has been collected
and therefore the
household would not
be entitled to a pass-
through for this
case.
15 Mother/ There are three $250 is collected on N/A $200 $200 $0 There is one TA-
Grandmother orders of support one of the CSMS CAN and four
(age 48), her payable through accounts. children under the
two children the SCU and age of 21 on the TA-
under the age three CSMS CAN.
of 21, and her accounts for the
two four children; one The household is
11
 Collections Pass-Through
For SSDs: For SCUs: Current for Non- Amount
Support Collections IV-D Determined for the
for IV-D Order of Order for Family IV-A
Support (either Spousal Amount Entered (IV-A Payment Disregard
Order for Payable through the Support in ABEL Input Type Codes D1 for Payment
IV-A Case Support Support Collection or Screen for the Rest of State, or 54 Type Code 18
Family and CSMS Unit or a Direct Pay Voluntary EXEMPT or 70 for New York for Rest of
Example Members Account Order) Collections FIELD City) State Only Summary
grandchildren for the NCP of entitled to a $200
under the age her own two pass-through (the
of 21. children; and one maximum allowed).
for each NCP of
the two
grandchildren.
16 Grandmother There are four $100 is collected on N/A $200 $200 $0 There is one TA-
(age 49) and orders of support the CSMS account CAN and four
her four payable through number 1. children under the
grandchildren the SCU and four age of 21 on the TA-
under the age CSMS accounts $100 is collected on CAN.
of 21. for the four the CSMS account
grandchildren; number 2. The household is
Two one CSMS entitled to a $200
grandchildren account for each $100 is collected on pass-through (the
are from NCP for the two the CSMS account maximum allowed).
daughter #1 grandchildren number 3.
(age 26) and from daughter
the other two #1; one CSMS $100 is collected on
grandchildren account for each the CSMS account
are from NCP of the two number 4.
daughter #2 grandchildren
(age 24). from daughter #2
17 Mother (age There is one $150 is collected on N/A $100 $100 $0 There is one TA-
23) and her order of support the CSMS account. CAN and one child
two children payable through under the age of 21
under the age the SCU and one on the TA-CAN.
of 21. CSMS account The SSI child is not
for the two considered an active
One child is children. child on the TA-
on SSI and CAN.
the second
12
 Collections Pass-Through
For SSDs: For SCUs: Current for Non- Amount
Support Collections IV-D Determined for the
for IV-D Order of Order for Family IV-A
Support (either Spousal Amount Entered (IV-A Payment Disregard
Order for Payable through the Support in ABEL Input Type Codes D1 for Payment
IV-A Case Support Support Collection or Screen for the Rest of State, or 54 Type Code 18
Family and CSMS Unit or a Direct Pay Voluntary EXEMPT or 70 for New York for Rest of
Example Members Account Order) Collections FIELD City) State Only Summary
child on TA. The household is
entitled to a $100
pass-through.
18 Mother (age There is one $150 is collected on N/A $200 $150 $0 There is one TA-
24) and her order of support the CSMS account $ 0 $ 50* CAN and two
two children payable through payable through the $150 TOTAL $50 TOTAL children under the
under the age the SCU and one SCU. age of 21.
of 21. CSMS account
for the first child Although the
The children $100 is collected for household would be
have different There is one the direct pay order. eligible for a pass-
absent order of support through of up to
parents. that is a direct $200 for two
pay order for the children under the
second child and age of 21, the
it has not yet household is limited
been made to a $150 pass-
payable through through for the
the SCU. CSMS account
made payable
through the Support
Collection Unit.

The household is
also entitled to an
additional $50
exempt amount
based on collections
received for the pay
direct order, for a
maximum of $200.
19 Mother (age There are two $150 is collected on N/A $150 (TA-CAN 1) $150 (TA-CAN 1) $0 There are two TA-
13
 Collections Pass-Through
For SSDs: For SCUs: Current for Non- Amount
Support Collections IV-D Determined for the
for IV-D Order of Order for Family IV-A
Support (either Spousal Amount Entered (IV-A Payment Disregard
Order for Payable through the Support in ABEL Input Type Codes D1 for Payment
IV-A Case Support Support Collection or Screen for the Rest of State, or 54 Type Code 18
Family and CSMS Unit or a Direct Pay Voluntary EXEMPT or 70 for New York for Rest of
Example Members Account Order) Collections FIELD City) State Only Summary
32) has two orders of support one of the CSMS $100 (TA-CAN 2) $100 (TA-CAN 2) CANs. Because
children payable through accounts for the $250 TOTAL $250 TOTAL there are two TA-
under the age the SCU and two mother’s own two CANs, the review
of 21. CSMS accounts children. for the pass-through
for the NCPs of must be conducted
The children the mother’s two $150 is collected on separately for each
have different children, and one the CSMS account TA-CAN.
absent order of support for the neighbor’s
parents. payable through child. TA-CAN number 1
the SCU and one has two children
Mother takes CSMS account under the age of 21;
in neighbor’s for the neighbor’s TA-CAN number 2
child under child. has one child under
the age of 21. 21.

Although the
household would be
eligible for a pass-
through of up to
$200 for two
children under the
age of 21, the pass-
through is limited by
the amount collected
of $150 for TA-
CAN number 1.

The household is
also entitled to a
$100 pass-through
for TA-CAN
number 2.
14
 Collections Pass-Through
For SSDs: For SCUs: Current for Non- Amount
Support Collections IV-D Determined for the
for IV-D Order of Order for Family IV-A
Support (either Spousal Amount Entered (IV-A Payment Disregard
Order for Payable through the Support in ABEL Input Type Codes D1 for Payment
IV-A Case Support Support Collection or Screen for the Rest of State, or 54 Type Code 18
Family and CSMS Unit or a Direct Pay Voluntary EXEMPT or 70 for New York for Rest of
Example Members Account Order) Collections FIELD City) State Only Summary
20 Mother (age There is one $250 is collected on N/A $100 $100 $0 There is one TA-
32) and one order of support the CSMS account. CAN and one child
child under payable through under the age of 21
the age of 21. the SCU and one on the TA-CAN.
CSMS account.
The household is
In addition, entitled to a $100
mother has a pass-through.
non-IV-D order
for spousal There is no
support from an collection for the
ex-husband (not non-IV-D order for
the NCP for the spousal support and
child). There therefore no
would be no additional exempt
CSMS account amount.
for the non-IV-D
order for spousal
support.
21 Mother (age There is one $250 is collected on N/A $0 $0 $0 There is one TA-
50) on Safety order of support the CSMS account CAN and no
Net payable through for the spousal children under the
Assistance the SCU and one support obligation. age of 21 on the TA-
and two CSMS account. CAN.
children over
the age of 21. The original The household is not
court order was entitled to a pass-
established for through.
child and spousal
support.

By operation of
15
 Collections Pass-Through
For SSDs: For SCUs: Current for Non- Amount
Support Collections IV-D Determined for the
for IV-D Order of Order for Family IV-A
Support (either Spousal Amount Entered (IV-A Payment Disregard
Order for Payable through the Support in ABEL Input Type Codes D1 for Payment
IV-A Case Support Support Collection or Screen for the Rest of State, or 54 Type Code 18
Family and CSMS Unit or a Direct Pay Voluntary EXEMPT or 70 for New York for Rest of
Example Members Account Order) Collections FIELD City) State Only Summary
law, the child
support is
terminated.
However, spousal
support is
collected prior to
CSMS case
closure.
22 Mother (age There is one $0 is collected on $150 is $0 $0 $0 There is one TA-
32) and one order of support the CSMS account. collected CAN and one child
child under payable through for the under the age of
the age of 21. the SCU and one non-IV-D 21on the TA-CAN.
CSMS account. order for
spousal The household is not
In addition, support. entitled to a pass-
mother has a through because the
non-IV-D collection is
spousal support received for a non-
order from an ex- IV-D order for
husband (not the spousal support.
NCP for the The $150 collection
child). is considered in
determining the
There would be grant amount. $150
no CSMS would be budgeted.
account for the
spousal support
order.
23 Single There is no order N/A $100 is $0 $0 $0 There is one TA-
woman, age of support for collected CAN and one child
20. child support or for the under the age of 21
CSMS account. non-IV-D (the single woman)
16
 Collections Pass-Through
For SSDs: For SCUs: Current for Non- Amount
Support Collections IV-D Determined for the
for IV-D Order of Order for Family IV-A
Support (either Spousal Amount Entered (IV-A Payment Disregard
Order for Payable through the Support in ABEL Input Type Codes D1 for Payment
IV-A Case Support Support Collection or Screen for the Rest of State, or 54 Type Code 18
Family and CSMS Unit or a Direct Pay Voluntary EXEMPT or 70 for New York for Rest of
Example Members Account Order) Collections FIELD City) State Only Summary
Note: Her order for on the TA-CAN.
date of birth There is a non- spousal
is June 15, IV-D order for support. The household is not
1989 spousal support entitled to a pass-
from an ex- through because
husband. there is no order of
support payable
There would be through the Support
no CSMS Collection Unit.
account for the The $100 collection
spousal support is considered in
order. determining the
grant amount. $100
is budgeted.

24 Mother (age There is one $150 is collected on N/A $150 $150 $0 There is one TA-
20) and one order for support the CSMS account. CAN and two
minor child. payable through children under the
the SCU and one age of 21 (including
CSMS account. the mother) on the
TA-CAN.
The order of
support includes Although the
both child and household would be
spousal support. eligible for a pass-
through of up to
$200 for two
children under the
age of 21, the pass-
through is limited by
the amount collected
17
 Collections Pass-Through
For SSDs: For SCUs: Current for Non- Amount
Support Collections IV-D Determined for the
for IV-D Order of Order for Family IV-A
Support (either Spousal Amount Entered (IV-A Payment Disregard
Order for Payable through the Support in ABEL Input Type Codes D1 for Payment
IV-A Case Support Support Collection or Screen for the Rest of State, or 54 Type Code 18
Family and CSMS Unit or a Direct Pay Voluntary EXEMPT or 70 for New York for Rest of
Example Members Account Order) Collections FIELD City) State Only Summary
of $150.
25 Mother (one There is one $150 is collected on N/A $100 $100 $0 There is one TA-
month after order of support the CSMS account CAN and one active
reaching the payable through child under the age
age 21) and the SCU and one of 21.
one minor CSMS account.
child The household is
The support order entitled to a $100
includes both pass-through.
child and spousal
support.

18
 REPORT OF SUPPORT COLLECTED

Line 1.
Line 2.

Case No.
Rpt. No.

Depending upon the number of individuals under the age of 21 active on your current Temporary
Assistance (TA) case, the Local Department of Social Services (LDSS) must pay you the first
$100 or $200 of support paid in the month it is due for someone in your household. This payment
is called a “pass-through” payment. This report summarizes the amount of support the LDSS
received for you last month. It also tells you the pass-through payment you will receive.

Line 1 is the amount of support received by LDSS last month that was due to be paid last month.
You will receive a pass-through payment of up to $100 of this amount if there is one individual
under the age of 21 active on your TA case or up to $200 of this amount if there are two or more
individuals under the age of 21 active on your TA case. This payment will not affect the amount
of your TA benefit but may affect the amount of your food stamp benefit next month. If Line 1
lists “0”, the LDSS did not receive a support payment for you last month and you will not receive
a pass-through payment.
Line 2 is the amount of support received by LDSS last month that was paid on time in previous
months but not received by LDSS until last month. If you did not already receive the full amount
of your pass-through payment for the month(s) when these payments were made, you will receive
an additional pass-through payment for those months. This payment will not affect your TA
benefit or your food stamp benefit. If Line 2 lists “0”, LDSS did not receive a support payment
for you last month for any prior months and you will not receive an additional pass- through
payment for those months.
You will receive your pass-through payment when you receive your TA payment via the
Electronic Benefit Transfer (EBT) system. Your EBT receipt will not separately identify this
payment. If you disagree with the amount of the payment, or have other questions regarding this
support pass-through payment, contact your TA worker at your local district. If your concern is
not resolved, you may call 1-888-208-4485 (TTY: 1-866-875-9975) Monday–Friday, 8:00
AM–7:00 PM, at no charge to you, to obtain the form for submitting your written request for a
desk review.
LDSS-3677 (Rev. 1/10) XL0031 (1/10)
 INFORME SOBRE EL
SUSTENTO COLECTADO

Línea 1.

Línea 2.

Caso No
Reporte No

Dependiendo del número de individuos menores de 21 años de edad activos en su caso de Asistencia Temporal
(TA), el departamento local de servicios sociales debe de pagarle a usted los primeros $100 ó $200 del sustento
recibido durante el mes en el que se vencían dichos pagos a nombre del integrante del grupo familiar. Dicho pago
se conoce como «pago traspasado». El presente informe resume el monto de sustento recibido en su nombre
durante el pasado mes por el departamento local de servicios sociales. También le informa del pago traspasado
que usted recibirá.

Línea 1 indica el monto de los pagos de sustento que el departamento local de servicios sociales recibió el mes
pasado y que se vencían el mes pasado. Usted recibirá un pago traspasado de hasta $100 de este monto si uno
de los individuos activos en su caso de Asistencia Temporal es menor de 21 años; o de hasta $200 de este
monto si hay dos o más individuos menores de 21 años activos en su caso de Asistencia Temporal. Este pago no
afectará negativamente el monto del beneficio de Asistencia Temporal que usted recibe; sin embargo, sí puede
afectar el monto del beneficio de cupones para alimentos que usted reciba el próximo mes. Si la línea 1 lee «0»,
ello quiere decir que el departamento local de servicios sociales no recibió en su nombre un pago de sustento el
mes pasado, y como resultado usted no recibirá un pago traspasado.

Línea 2 muestra el monto de sustento recibido el mes pasado por el departamento local de servicios sociales que
fue hecho a tiempo en meses previos pero que no fue recibido por el departamento local de servicios sociales
sino hasta el mes pasado. Si usted aún no ha recibido el monto completo de su pago traspasado para el / los
mes(es) cuando estos pagos de hicieron, usted recibirá un pago traspasado adicional correspondiente a esos
meses. Ese pago no afectará de manera negativa su beneficio de Asistencia Temporal o su beneficio de cupones
para alimentos. Si la línea 2 lee «0», ello quiere decir que el departamento de servicios sociales no recibió en su
nombre un pago de sustento el mes pasado correspondiente a los meses previos, y por lo tanto, usted no recibirá
un pago traspasado adicional para esos meses.

Usted recibirá su pago traspasado cuando reciba su pago de Asistencia Temporal por medio del sistema de
Transferencia Electrónica de Beneficios (EBT). Su recibo de EBT no identificará este pago por separado. Si
usted no está de acuerdo con el monto del pago o tiene otras preguntas pertinentes a este pago traspasado,
comuníquese con el trabajador de casos que administra su caso de Asistencia Temporal en su distrito local. Si no
resolvemos su problema, puede llamar gratis al 1-888-208-4485 (TTY: 1-866-875-9975) de lunes a viernes, de
8:00 AM a 7:00 PM y solicitar el formulario para la petición por escrito de una revisión.

LDSS-3677 SP (Rev. 1/10) XL031B (1/10)

 REPORT OF SUPPORT COLLECTED

Line 1.
Line 2.
Case No.
Rpt. No.

Depending upon the number of individuals under the age of 21 active on your current Temporary
Assistance (TA) case, the Human Resources Administration (HRA) must pay you the first $100
or $200 of support paid in the month it is due for someone in your household. This payment is
called a “pass-through” payment. This report summarizes the amount of support HRA received
for you last month. It also tells you the pass-through payment you will receive.

Line 1 is the amount of support received by HRA last month that was due to be paid last month.
You will receive a pass-through payment of up to $100 of this amount if there is one individual
under the age of 21 active on your TA case or up to $200 of this amount if there are two or more
individuals under the age of 21 active on your TA case. This payment will not affect the amount
of your TA benefit but may affect the amount of your food stamp benefit next month. If Line 1
lists “0”, HRA did not receive a support payment for you last month and you will not receive a
pass-through payment.
Line 2 is the amount of support received by HRA last month that was paid on time in previous
months but not received by HRA until last month. If you did not already receive the full amount
of your pass-through payment for the month(s) when these payments were made, you will receive
an additional pass-through payment for those months. This payment will not affect your TA
benefit or your food stamp benefit. If Line 2 lists “0”, HRA did not receive a support payment for
you last month for any prior months and you will not receive an additional pass- through payment
for those months.
You will receive your pass-through payment when you receive your TA payment via the
Electronic Benefit Transfer (EBT) system. Your EBT receipt will not separately identify this
payment. If you disagree with the amount of the payment, or have other questions regarding this
support pass-through payment, contact the HRA Information Line at 1-877-472-8411, and
outside New York City at (718) 557-1399. If your concern is not resolved, you may call 1-888-
208-4485 (TTY: 1-866-875-9975) Monday–Friday, 8:00 AM–7:00 PM, at no charge to you, to
obtain the form for submitting your written request for a desk review.
LDSS-3677 NYC (Rev. 1/10) XL0032 (1/10)
 INFORME SOBRE EL
SUSTENTO COLECTADO

Línea 1.
Línea 2.

Caso No.
Reporte No.

Dependiendo del número de individuos menores de 21 años de edad activos en su caso de Asistencia Temporal
(TA), la Administración de Recursos Humanos (HRA, por sus siglas en inglés), debe pagarle a usted los
primeros $100 ó $200 del sustento recibido durante el mes en el que se vencían dichos pagos a nombre del
integrante del grupo familiar. Dicho pago se conoce como «pago traspasado». El presente informe resume el
monto de sustento recibido en su nombre durante el pasado mes por la Oficina HRA. También le informa del
pago traspasado que usted recibirá.

Línea 1 indica el monto de los pagos de sustento que la Oficina HRA recibió el mes pasado y que se vencían el
mes pasado. Usted recibirá un pago traspasado de hasta $100 de este monto si uno de los individuos activos en
su caso de Asistencia Temporal es menor de 21 años; o de hasta $200 de este monto si hay dos o más individuos
menores de 21 años activos en su caso de Asistencia Temporal. Este pago no afectará negativamente el monto
del beneficio de Asistencia Temporal que usted recibe; sin embargo, sí puede afectar el monto del beneficio de
cupones para alimentos que usted reciba el próximo mes. Si la línea 1 lee «0», ello quiere decir que la Oficina de
HRA no recibió en su nombre un pago de sustento el mes pasado, y como resultado usted no recibirá un pago
traspasado.

Línea 2 muestra el monto de sustento recibido el mes pasado por la Oficina de HRA que fue hecho a tiempo en
meses previos pero que no fue recibido por la HRA sino hasta el mes pasado. Si usted aún no ha recibido el
monto completo de su pago traspasado para el / los mes(es) cuando estos pagos de hicieron, usted recibirá un
pago traspasado adicional correspondiente a esos meses. Ese pago no afectará de manera negativa sus beneficios
de Asistencia Temporal o su beneficio de cupones para alimentos. Si la línea 2 lee «0», ello quiere decir que la
Oficina de HRA no recibió en su nombre un pago de sustento el mes pasado correspondiente a los meses
previos, y por lo tanto, usted no recibirá un pago traspasado adicional para esos meses.

Usted recibirá su pago traspasado cuando reciba su pago de Asistencia Temporal por medio del sistema de
Transferencia Electrónica de Beneficios (EBT). Su recibo de EBT no identificará este pago por separado. Si
usted no está de acuerdo con el monto del pago o tiene otras preguntas relacionadas con este pago traspasado de
sustento, comuníquese con la Línea de Información de la Oficina de HRA al 1-877-472-8411; fuera de la Ciudad
de Nueva York al (718) 557-1399. Si no podemos resolver su problema, puede llamar gratis al 1-888- 208-4485
(TTY: 1-866-875-9975) de lunes a viernes, de 8:00 AM a 7:00 PM y solicitar el formulario para la petición por
escrito de una revisión.
LDSS-3677- NYC SP (Rev. 1/10) XL032B (1/10)
LDSS-4279 (Rev. 1/10) NYS OTDA
NOTICE OF RESPONSIBILITIES AND RIGHTS FOR SUPPORT
YOUR RESPONSIBILITIES
When you sign a Temporary Assistance (TA) Medical Assistance (MA) application, and for as long as you get TA and/or MA, you must:
I. Tell your worker if you are pregnant or were pregnant in the last two months because some of the requirements below may not apply to you at
this time.
II. Turn over (“assign”) to the State and your local Department of Social Services (“the Department”) your rights and the rights of any applying
family member to get support (including medical support) from anyone else. [Social Services Law (SSL) 158 and 348] The assignment of
support is limited to support which accrues during the period that you and/or any family member receives assistance. If you are applying only
for MA, you assign to the State and the Department your rights and the rights of any applying family member to get medical support including
the rights to any medical benefits. [SSL 366(4)(h)]
III. Cooperate with the Department to legally name who the father of your child is (“establish paternity”) and to get any support (including medical
support) owed to you and any child living with you [SSL 132-a, 158, 349-b and 366(4)(h)]. If you have a good reason not to cooperate, be sure
to read the “YOUR RIGHTS IF YOU DO NOT COOPERATE” section below.
To cooperate means you will have to:
♦ Go to the TA office and, if required, to the child support office and court to sign papers or tell what you know about the absent parent.
Some things that you may be asked you may already know. See the back of this form for the section on “Information You May Already Have
On The Absent Parent”.
♦ Name the absent parent of any child applying for or getting TA or MA, and tell what you know to help find that parent.
♦ Help the court in establishing paternity of any child who was born to unmarried parents.
♦ Tell what you know about the absent parent’s income and whether the absent parent has access to health insurance benefits to help the
Department help you or any child getting TA or MA to get financial and/or medical support.
NOTE: By signing the TA/MA application, you are attesting under penalty of perjury that you will give true and complete information. If you
don't know information about the parent of your child, you must sign a form saying you don’t know.
A child should get support from both parents. By cooperating, you are investing in your child’s future. Some of the benefits of cooperating are:
♦ Finding the absent parent
♦ Establishing the paternity of your child is (see the back of this form for the section on “Fathers’ Rights When Paternity is Established in
Court”)
♦ Up to $100 per month of current support collected is given to you if there is one child active on your TA case (this is called a “pass-through” or
“bonus” check); up to $200 per month of current support collected is given to you if there are two or more children active on your TA case.”
♦ Getting support that could help you so that you might not need TA
♦ Your child gains inheritance rights to medical and life insurance
♦ You and your child gain rights to future Social Security, Veteran’s or other government benefits.
YOUR RIGHTS IF YOU DO NOT COOPERATE
I. If you feel that cooperating would not be good for you or your child:
A. You have the right to make a “good cause claim” for not cooperating. The following are reasons that the Department will use to see if it can
approve your good cause claim:
♦ Your cooperation is likely to cause physical or emotional harm to you or your child
♦ Your child came from a pregnancy due to incest or rape
♦ You are working with the court or an authorized adoption agency to have your child adopted.
B. You have the right to make a “good cause claim” at any time by telling a worker. If you make a good cause claim, you must:
♦ Give evidence to the Department to prove this. See the back of this form for the section on “Examples Of Evidence You Can Give For A
Good Cause Claim”. If you need help getting the evidence, the Department will give you reasonable help. If your claim is due to fear of
physical harm, and you cannot get the evidence, the Department may still be able to approve your good cause claim.
♦ Give your evidence within 20 days of making your good cause claim. You may only have 20 days even if you have a hard time getting
evidence.
NOTE: If you are applying for TA or MA, you must give evidence and tell what you know about the absent parent, or you will get less TA and you will
not get MA for yourself.
Once you make a good cause claim, the Department will do one of the following:
♦ Approve your claim based on the evidence you have given to prove one of the good cause reasons listed in Section I.A. above. If your claim is
approved, you will not have to cooperate with the Department.
♦ Deny your claim because the evidence you gave was not enough to prove one of the reasons listed in Section I.A. above.
♦ Look into (“investigate”) your claim further so that the Department can get the information it needs to see if it can approve your claim. You may
have to tell what you know about the absent parent, such as their name and address. The Department will not contact the absent parent without
telling you first.
NOTE: The Child Support Enforcement Unit (CSEU) may review the Department’s findings and the good cause decision. If you ask for a
hearing on your good cause claim, the CSEU may be involved with that hearing. If your good cause claim is approved, the CSEU may
try to establish paternity or collect support only if the Department decides that this can be done without risk to you or your child. This
will not be done without telling you first.
II. If you do not cooperate and do not have a good cause claim or domestic violence waiver that was approved:
♦ You will get less TA and will not get MA for yourself. ♦ TA for your child may be paid to someone else called a “protective payee”.
I have read the front and back of this notice, I have given the
I can cooperate in pursuing child support without exposing my children or myself to physical or emotional harm. applicant/recipient a
I cannot pursue child support, as it would expose my children or myself to physical or emotional harm. copy of this notice.
SIGNATURE OR APPLICANT/RECIPIENT DATE SIGNATURE OF WORKER DATE
LDSS-4279 (Rev. 1/10) Reverse NYS OTDA

I. INFORMATION YOU MAY ALREADY HAVE ON THE ABSENT PARENT(S)

You will be asked to give as much information about the absent parent(s) as possible. Social Security Number(s) and date(s)
of birth are especially important. This information may be found on the absent parent’s following documents:
♦ Pay stubs ♦ Life and auto insurance policies
♦ Tax returns (may be joint returns) ♦ Bank books (current and old)
♦ Tax Department forms and letters ♦ Medical/Dental records and bills
♦ Unemployment Benefits (UIB) booklet ♦ Marriage certificate
♦ Social Security/Veterans Administration records ♦ ID cards (health insurance, school ID, alien registration)
♦ Workers’ Compensation statement ♦ Other personal records
♦ School/College records

II. EXAMPLES OF EVIDENCE YOU CAN GIVE FOR A GOOD CAUSE CLAIM:
♦ Birth Certificate, or medical or law enforcement records, which show that your child came from a pregnancy due to incest
or rape
♦ Court records or other records which show that action on a legal adoption is pending in court.

♦ Court, medical, criminal, child protective services, social services, psychological or law enforcement records which show
that the alleged or absent parent might physically or emotionally harm you or your child.

♦ Medical records which show emotional health history and present health history and present health status of you or your
child; or written statements from mental health staff showing a diagnosis or prognosis on the emotional health of you or
your child.

♦ A written statement from a public or private agency that you are being helped to decide whether to keep or give up your
child for adoption.

♦ Sworn statements from people including friends, neighbors, clergy, social workers and medical staff who would know your
situation and could confirm the basis of your good cause claim.

If you need help in getting evidence, ask the Department. The Department will give you reasonable help in getting the
evidence you need.

III. FATHERS’ RIGHTS WHEN PATERNITY IS ESTABLISHED IN COURT

When a court has established who is the father of a child, or when a mother and father acknowledge that he is the child’s
father by signing an Acknowledgment of Paternity form anytime after the child is born, the father may ask to:

♦ Get custody of the child

♦ Visit with the child

♦ Take part in any adoption or foster care plans for the child

♦ Disagree with any adoption or foster care placements of the child

♦ Inherit from the child

LDSS-4279-SP (Rev. 1/10) NYS OTDA
AVISO SOBRE DEBERES Y DERECHOS DE SUSTENTO
SUS DEBERES
Cuando firma una solicitud de Asistencia Temporal (TA) o de Asistencia Médica (MA) y mientras reciba TA o MA, usted debe:
I. Avisar a su empleador si está embarazada o estuvo embarazada durante los últimos dos meses ya que algunos de los requisitos que figuran
más abajo pueden no ser aplicables para usted en este momento.
II. Transferir (“ceder”) al Estado y a su departamento local de servicios sociales (“el Departamento”) sus derechos y los derechos de cualquier
miembro de la familia que solicite sustento (entre ellos, gastos médicos) de cualquier otra persona. (Ley de Servicios Sociales [SSL], 158 y
348). La cesión de sustento está limitada al sustento devengado durante el período en que usted o cualquier miembro de la familia reciben
asistencia. Si usted solicita solamente MA, cede al Estado y al Departamento sus derechos y los derechos de cualquier miembro de la familia
que solicite ayuda médica, inclusive los derechos a cualquier beneficio médico (SSL 366[4][h]).
III. Cooperar con el Departamento para nombrar legalmente al padre del niño (“establecer la paternidad") y recibir cualquier sustento (inclusive
ayuda médica) que se le deba a usted y a cualquier niño que viva con usted (SSL 132-a, 158, 349-b y 366[4] [h]). Si tiene una buena razón para
no cooperar, asegúrese de leer la sección «SUS DERECHOS SI NO COOPERA» que se encuentra más abajo.
Cooperar significa que usted tendrá que:
♦ Dirigirse a la oficina de Asistencia Temporal (TA) y, si se le solicita, a la oficina de Sustento de Menores y firmar los documentos o declarar lo que
sepa acerca del padre ausente.
Quizás sepa algunos de los datos que le pueden pedir. Consulte la sección «Datos que usted pueda tener sobre el padre ausente» al reverso
de esta solicitud.
♦ Nombrar al padre ausente de cualquier niño que solicite o esté recibiendo TA o MA y proporcionar cualquier dato que sea útil para encontrar al
padre.
♦ Ayudar a la corte a establecer la paternidad de todo hijo de padres no casados.
♦ Declarar lo que sepa respecto los ingresos del padre ausente e informar si el padre ausente tiene acceso a beneficios de seguro de salud para
colaborar con el Departamento para que lo ayude a usted o a todo niño que reciba TA o MA a obtener sustento financiero o médico.

NOTA: cuando firma la solicitud de TA / MA, usted está atestiguando so pena de perjurio que otorgará información verdadera y completa. Si usted
no tiene información acerca del padre de su hijo, debe firmar un formulario declarando que no la tiene.
El niño debe recibir sustento por parte de ambos padres. Cooperando, usted invierte en el futuro de su hijo. Algunas de las ventajas por cooperar son:
♦ Se encuentra al padre ausente
♦ Se establece la paternidad de su hijo (consulte la sección, al reverso de este formulario, «Derechos del padre una vez establecida la
paternidad ante un Tribunal»).
♦ Si hay un niño activo en su caso de TA, se le entregan hasta $100 por mes del pago actual de sustento (ello se denomina pago «traspasado» o
«bonificación»); si hay dos o más niños activos en su caso de TA se le entregan hasta $200 por mes del pago actual de sustento.
♦ Recibir apoyo que puede ayudarlo a no necesitar de los servicios de Asistencia Pública.
♦ Su hijo obtiene derechos hereditarios sobre el seguro de salud y de vida.
♦ Usted y su hijo obtienen derechos a un seguro social, de veteranos u otro beneficio gubernamental en el futuro.
SUS DERECHOS SI NO COOPERA
I. Si usted considera que cooperar sería problemático para usted o su hijo:
A. Tiene derecho a alegar «motivo justificado» por su falta de cooperación. A continuación citamos los motivos por los cuales el Departamento
aceptaría un motivo justificado:
♦ Su cooperación puede causar daños físicos u emocionales a usted o a su hijo
♦ Su hijo fue gestado como resultado de incesto o violación.
♦ Usted está trabajando con el tribunal o con una agencia de adopción autorizada para dar a su hijo en adopción.
B. Usted tiene el derecho de alegar «motivo justificado» cuando los desee informándoselo al trabajador social. Si desea presentar motivo justificado
usted debe:
♦ Presentar pruebas ante el Departamento que avalen dicho motivo. Consulte la sección al dorso de este formulario titulada «Ejemplos de
pruebas que puede someter para establecer un motivo justificado». Si necesita ayuda para obtener pruebas, el Departamento le brindará
ayuda razonable. Si su motivo justificado es temor a sufrir daños físicos, y no puede obtener los comprobantes, es posible que el
Departamento pueda aprobar su motivo justificado.
♦ Presentar sus pruebas dentro de los 20 días de alegar motivo justificado. Posiblemente sólo tenga 20 días, aún cuando tenga dificultades
para obtener las pruebas.
NOTA: si está solicitando Asistencia Temporal o Asistencia Médica, debe presentar pruebas y declarar lo que sepa acerca del padre ausente o
recibirá cantidad reducida de asistencia temporal y no recibirá asistencia médica para usted.
Una vez que alega motivo justificado, el Departamento realizará alguna de las siguientes acciones:
♦ Aprobar su motivo justificado en base a las pruebas presentadas que demuestren una de las razones que figura en la sección I.A. anterior. Si se
aprueba su motivo, no tendrá que cooperar con el Departamento.
♦ Rechazar su motivo justificado porque la evidencia que presentó no fue suficiente para probar una de las razones que figura en la sección I.A.
arriba.
♦ Estudiar («investigar») más a fondo su reclamación con motivo de darle al Departamento la oportunidad de obtener los datos que necesita con
motivo de poder aprobar su reclamación. Quizás deba declarar lo que sabe acerca del padre ausente, como por ejemplo el nombre y la dirección.
El Departamento no hará contacto con el padre ausente sin avisárselo a usted primero.
NOTA: la Unidad de Ejecución de Pagos de Sustento de Menores (CSEU) podrá estudiar la decisión tomada por el Departamento y la decisión sobre
el motivo justificado. Si solicita una audiencia a raíz de su motivo justificado, la CSEU puede participar en esa audiencia. Si su motivo
justificado es aprobado, la CSEU puede tratar de establecer la paternidad o de recaudar sustento sólo si el Departamento decide que se
puede hacer sin que usted o su hijo corran riesgos. Ello no se realizará sin avisarle a usted primero.
II. Si usted no coopera y no tiene un motivo justificado o una dispensa aprobada por temor a violencia doméstica:
♦ Recibirá un monto reducido de asistencia temporal y ♦ La asistencia temporal de su hijo se podrá pagar a otra persona denominada
no recibirá asistencia médica para usted. «beneficiario protector».

He leído el anverso y reverso de este aviso, He entregado una

Puedo cooperar para obtener sustento de menores sin exponer a mi hijo o a mi misma a daño físico u emocional. copia de este aviso al
No puedo solicitar sustento de menores, ya que al hacerlo estaría corriendo el riesgo de exponerme a mí o a mi hijo a solicitante / beneficiario.
daños físicos o emocionales.
FIRMA DEL SOLICITANTE / BENEFICIARIO FECHA FIRMA DEL TRABAJADOR DE CASOS FECHA
LDSS-4279-SP (Rev. 1/09) Dorso NYS OTDA

I. INFORMACIÓN QUE PUEDA TENER SOBRE EL/LOS PADRE(S) AUSENTE(S)

Se le solicitará que brinde toda la información que pueda acerca del/los padre(s) ausente(s). El número de seguro social y la
fecha de nacimiento son especialmente importantes. Dichos datos los puede obtener en los documentos del padre ausente
(vea la lista a continuación):
♦ Talones de cheque de pago ♦ Pólizas de seguro de vida y automóvil
♦ Declaración de impuestos (puede ser declaración ♦ Libretas bancarias (actuales y anteriores)
conjunta)
♦ Formularios y cartas del Departamento de Impuestos ♦ Historias clínicas y facturas médicas / odontológicas
♦ Libreta de beneficios de desempleo (UIB) ♦ Certificado de matrimonio
♦ Registros de la Administración del Seguro Social o de ♦ Tarjetas de identificación (seguro médico, identificación
Veteranos escolar, registro de extranjero)
♦ Declaración de Indemnización laboral ♦ Otros registros personales

♦ Registros escolares / universitarios

II. EJEMPLOS DE PRUEBAS QUE PUEDE PRESENTAR PARA ALEGAR UN MOTIVO

JUSTIFICADO:
♦ Certificado de nacimiento o registro médico o de las fuerzas de seguridad, que demuestren que su hijo fue gestado como
resultado de incesto o violación.
♦ Registros del tribunal u otros registros que demuestren que el tribunal está tramitando el caso para dar a su hijo en
adopción.
♦ Registros judiciales, expedientes médicos, expedientes penales, registros de servicios de protección al menor o de
servicios sociales, expedientes psicológicos o de las fuerzas de seguridad que demuestren que el padre ausente puede
dañar física o emocionalmente a usted o a su hijo.
♦ Registros médicos con la historia de salud emocional y el estado de salud actual suyo o de su hijo, o declaraciones
escritas del personal de salud mental con el diagnóstico o pronóstico suyo o de su hijo.
♦ Una declaración escrita de una agencia pública o privada que certifique que la están ayudando a decidir si continuar o no
con el trámite para dar a su hijo en adopción.
♦ Declaraciones juradas de personas, que pueden incluir amigos, vecinos, sacerdotes, trabajadores sociales y personal
médico que conocen su situación y pueden confirmar que usted tiene un motivo justificado.
Si necesita ayuda para recabar pruebas, puede pedírsela al Departamento. El Departamento le dará toda la ayuda
razonable para recabar las pruebas que necesita.

III. DERECHOS DEL PADRE UNA VEZ QUE SE HA ESTABLECIDO LA PATERNIDAD

ANTE UN TRIBUNAL
Cuando el tribunal establece quién es el padre del niño, o cuando la madre y el padre reconocen quién es el padre del niño
firmando un Reconocimiento de Paternidad después del nacimiento del niño, el padre puede solicitar:

♦ Obtener la custodia del niño

♦ Visitar al niño

♦ Participar en planes de adopción o cuidados de crianza del niño

♦ Manifestar desacuerdo con los planes de adopción o cuidados de crianza del niño

♦ Recibir herencia del niño

 LDSS-3908 (Rev. 10/ 09)
IMPORTANT NOTICE REGARDING CHILD SUPPORT
TO PERSONS APPLYING FOR OR RECEIVING TEMPORARY ASSISTANCE OR FOSTER
CARE MAINTENANCE PAYMENTS UNDER TITLE IV-E

Assignment and Cooperation with Child Support

As an applicant for or recipient of “temporary assistance” (officially known as “family assistance” and “safety net
assistance”) or, where appropriate, certain foster care maintenance payments, you are required to assign to the
Department any 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. Where 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 (CSEU) to:
Establish paternity of each child born out-of-wedlock for whom you are applying for, or receiving, temporary
assistance;
Locate noncustodial parents, including biological parents, stepparents, or adoptive parents;
Establish, modify or adjust child support obligations from the noncustodial parent of each child; and
Collect and enforce support obligations through the Support Collection Unit from noncustodial parents for the
support of each child.

Rights and Obligations Which May Result From Establishing Paternity

If paternity establishment is necessary, the court order establishing paternity (called an “order of filiation”) will
name the father of your child.
The noncustodial parent will be chargeable by the court to pay support until the child is twenty-one (21) years of
age. As a recipient of temporary assistance, you will receive up to the first $100 of current support collected each
month or up to the current support obligation amount, whichever is less, without reducing your assistance
grant or affecting your eligibility for assistance. This is referred to as the “pass-through” payment. Effective
January 1, 2010, the $100 pass-through payment level will continue for temporary assistance families with one
child but will also increase to up to the first $200 each month of current support collected or up to the current
support obligation amount, whichever is less, for temporary assistance families with two or more children.
Your child gains right to inheritance from his or her parents. Parents also may have rights of inheritance from their
child.
Your child may be entitled to receive death or disability benefits if either parent dies or becomes permanently
disabled.
The noncustodial parent has the right to ask the court for visitation with and/or custody of your child.
The noncustodial parent will also have the right to be consulted before any adoption or foster care placement
proceedings may occur for your child and may oppose any such adoption or foster care placement.

Rights to Information Regarding Legal Proceedings

You have the right to be kept informed of the time, date and place of any court proceedings involving you. You will be
provided with a copy of any order establishing, modifying, adjusting or enforcing a child support obligation or, in the case of
modification or adjustment, a determination that no change is warranted.

Legal Representation
An attorney will be assigned to your case for any actions that require a court proceeding. The attorney assigned to your case
is the legal representative of the Commissioner of the Department of Social Services, and does not represent you personally.
The attorney’s representation in this matter is limited to the establishment of paternity and the establishment, modification,
adjustment, and enforcement of support obligations. Matters of custody, visitation, or other issues not related to support will
not be handled by the Department’s attorney. Any information, written or oral, which you provide to the Department’s
attorney or staff may not remain confidential, including information indicating welfare fraud, which must be reported to
appropriate officials.

If you have any questions concerning other legal issues, or you wish to have your own legal representation, you should
contact a legal services or legal aid organization for assistance, or obtain the services of a private attorney of your own
choosing at your own expense.
 LDSS-3908 SP (Rev. 10/ 09)

AVISO IMPORTANTE EN RELACIÓN CON EL SUSTENTO DE MENORES PARA

SOLICITANTES O BENEFICIARIOS DE ASISTENCIA TEMPORAL O DE PAGOS DE
MANTENIMIENTO DE CUIDADO DE CRIANZA SEGÚN EL TÍTULO IV-E.
Asignación y cooperación con el sistema de sustento de menores
En su calidad de solicitante o beneficiario de «Asistencia Temporal» (oficialmente denominada «Asistencia para
Familias» y «Asistencia Red de Seguridad») o, de ser pertinente, de ciertos pagos de mantenimiento de cuidado de
crianza, se le exige asignar todos sus derechos de sustento al departamento en su propio nombre, y los derechos de
sustento de todo miembro de la familia para quien usted esté solicitando o recibiendo asistencia. Siempre que solicite
o reciba asistencia temporal, la asignación de derechos de sustento se limita al monto de sustento acumulado durante
el periodo en el cual usted o miembros de la familia reciben asistencia. Se le exige asignar esos derechos de sustento
y, a menos que usted aduzca causa o violencia doméstica como motivo para no hacerlo, que coopere con la Unidad de
Ejecución de Pago de Sustento de Menores (Child Support Enforcement Unit , CSEU), a fin de:
establecer la paternidad de cada niño nacido fuera del matrimonio para quien usted solicite o reciba asistencia
temporal;
localizar los padres no custodios, inclusive los padres biológicos, la madrastra / el padrastro o los padres adoptivos;
establecer o modificar la obligación de sustento de menores del padre no custodio del niño; y
cobrar y ejecutar la obligación de sustento por medio de los servicios de la Unidad de Cobro de Sustento del padre
no custodio del niño.
Derechos y obligaciones vinculadas con el establecimiento de paternidad
Si es necesario determinar paternidad, la orden judicial por la cual se la determine (llamada «orden de filiación»)
identificará al padre de su hijo.
Se le obligará al padre no custodio a pagar sustento de menores hasta que el niño cumpla los veintiún (21) años de
edad. Como beneficiario de Asistencia Temporal, usted recibirá una suma de hasta los primeros $100 del sustento
actual de menores cobrado cada mes o una suma de hasta el monto obligatorio actual de sustento, cualesquiera del
monto que sea menor, sin reducir su subvención de asistencia ni afectar su habilitación para recibir asistencia. Ello
se denomina «pago traspasado». A partir del 1 de enero de 2010, el pago traspasado por el monto de $100
continuará vigente para las familias con un niño beneficiario de Asistencia Temporal, y se incrementará a una suma
de hasta los primeros $200 del sustento actual cobrado cada mes o una suma de hasta el monto obligatorio actual de
sustento, cualesquiera del monto menor, para familias con dos o más niños beneficiarios de Asistencia Temporal.
Su hijo adquiere derechos de herencia de los padres. Los padres también adquieren derechos de herencia de sus
hijos.
Su hijo puede tener el derecho de recibir beneficios por fallecimiento o incapacidad de los padres si uno de ellos
muere o queda permanentemente incapacitado.
Cualquiera de los padres no custodios tiene el derecho de solicitarle al juzgado derecho de visita o derecho de
custodia del niño.
El padre no custodio también tendrá el derecho de que se le consulte antes de llevarse a cabo cualquier proceso de
adopción o colocación en familia de crianza de su hijo y puede oponerse a tal adopción o colocación en familia de
crianza.
Derechos a información relativa a procedimientos legales
Usted tiene el derecho de que se le informe la hora, la fecha y el lugar de todo procedimiento legal que lo/la involucre. Se le
proporcionará una copia de toda orden de establecimiento, modificación, ajuste o cumplimiento de una obligación de sustento
de menores o, en el caso de una modificación o ajuste, una determinación de que un cambio no tiene mérito.

Representación legal
Se asignará un abogado a su caso para toda acción que requiera un proceso legal. El abogado asignado a su caso es el
representante legal del Comisionado del Departamento de Servicios Sociales y no es su representante personal. La
representación del abogado en esta materia está limitada al establecimiento de paternidad y al establecimiento, modificación,
ajuste, y ejecución de obligaciones de sustento. Los casos de custodia, derechos de visita y otros temas no relacionados con el
sustento no serán tratados por el abogado del departamento. Toda información, escrita u oral, que usted le proporcione al
abogado o al personal del departamento no se mantendrá, necesariamente, de manera confidencial, inclusive datos
pertinentes a fraude en prestaciones sociales, de lo que deberá darse parte a las autoridades pertinentes.
Si usted tiene alguna pregunta en relación con otros temas legales o si desea su propia representación legal, debe ponerse en
contacto con una organización de servicios legales o de ayuda legal para recibir asistencia, o debe obtener los servicios de un
abogado privado, de su elección y por su cuenta.