5101:12-1-99. Chapter 5101:12-1 forms - Ohio support enforcement program


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  • The forms identified in this rule are referenced within various rules contained within division 5101:12 of the Administrative Code. The effective or revised effective dates of the forms are as follows:

    (A) JFS 01709, "Confidentiality of Information Reference Guide" (11/2011);

    (B) JFS 01728, "Daily Time Sheet for Non-Dedicated Principal Staff" (2/2009);

    (C) JFS 01729, "Monthly Time Sheet Summary for Non-Dedicated Principal Staff" (2/2009);

    (D) JFS 01730, "Dedicated Principal Staff Exception Report" (2/2009);

    (E) JFS 01731, "Monthly Time Summary for Governmental Contractor" (2/2009);

    (F) JFS 01772, "IV-D Contract Cover Letter" (rev. 5/2013);

    (G) JFS 02015, "IV-D Contract Time Study" (rev. 2/2009);

    (H) JFS 02151, "IV-D Contract Evaluation" (rev. 5/2013);

    (I) JFS 02750, "CFIS Local Agency Quarterly Financial Statement" (rev. 10/2011)

    (J) JFS 04001, "Request for Case Information" (11/2011);

    (K) JFS 04234, "Annual Full-Time Equivalent Report" (rev. 1/2008);

    (L) JFS 07014, "Tax Information Safeguarding Authorization Agreement" (rev. 4/2008);

    (M) JFS 07015, "Certification of Compliance with Competitive Sealed Bid Requirements" (rev. 2/2009);

    (N) JFS 07016, "IV-D Contract Security Addendum" (rev. 2/2009);

    (O) JFS 07018; "IV-D Contract" (rev. 12/2013);

    (P) JFS 07019, "Federal Tax Information Item Tracking Log" (4/2008);

    (Q) JFS 07020, "Governmental Contractor IV-D Contract Budget" (rev. 2/2009);

    (R) JFS 07034, "Governmental Contractor Monthly Expense Report" (rev. 2/2009);

    (S) JFS 07035, "IV-D Contract Invoice" (rev. 2/2009);

    (T) JFS 07037, "IV-D Contract Amendment" (rev. 12/2013);

    (U) JFS 07038, "Acknowledgment of Paternity Affidavit" (5/2014);

    (V) JFS 07072, "Safeguarding of Internal Revenue Service (IRS), Ohio Department Of Taxation (ODT), Federal Parent Locator Service (FPLS), and Unemployment Compensation (UC) Information" (rev. 3/2019);

    (W) JFS 07078, "Code of Responsibility" (rev. 6/2018);

    (X) JFS 07700, "SETS User Access Application" (rev. 3/2019);

    (Y) JFS 07713, "Child Welfare Agency Locate-Only Request" ( rev.4/2018);

    (Z) JFS 07729, "FTI Safeguarding Workbook" (4/2018);

    (AA) JFS 07766, "Child Support Guideline Manual" (3/2019);

    (BB) JFS 07767, "Ohio Basic Child Support Guideline Schedule" (3/2019);

    (CC) JFS 07768, "Sole/Shared Child Support Computation Worksheet" (3/2019);

    (DD) JFS 07769, "Split Parenting Child Support Computation Worksheet" (3/2019); and

    (EE) ODMODM 06613, "Accident/Injury Insurance Information" (rev. 12/2016).


Effective: 3/28/2019
Five Year Review (FYR) Dates: 11/30/2018 and 03/28/2024
Promulgated Under: 119.03
Statutory Authority: 3125.25
Rule Amplifies: 3125.03, 3125.25
Prior Effective Dates: 05/01/2014, 06/01/2015, 04/01/2018