Form 1 Status of Application Report

OMB Control No: 0970-0488

Expiration date: XX/XX/XXXX

Convention on the International Recovery of Child Support and Other Forms of Family Maintenance

Status of Application Report – Article 12¹

(Application for Recognition or Recognition and Enforcement ( Article 10(1) a)  Article 10(2) a)  Article 30))

CONFIDENTIALITY AND PERSONAL DATA PROTECTION NOTICE

Personal data gathered or transmitted under the Convention shall be used only for the purposes for which it was gathered or transmitted. Any authority processing such information shall ensure its confidentiality, in accordance with the law of its State.

An authority shall not disclose or confirm information gathered or transmitted in application of this Convention if it determines that to do so could jeopardise the health, safety or liberty of a person in accordance with Article 40.

• A determination of non-disclosure has been made by a Central Authority in accordance with Article 40.

Requested Central Authority Address Telephone number Fax number E-mail Reference number	Contact person in requested State Address (if different) Telephone number (if different) Fax number (if different) E-mail (if different) Language(s)
First Report /  Subsequent Report – Date of last Report: (dd/mm/yyyy)

3. File identification

   1. Requesting Central Authority file reference number:

   2. Family name(s) of applicant:

or

2. Name of public body:

and

2. Family name(s) of the person(s) for whom

maintenance is sought or payable:

2. Family name(s) of debtor:

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to provide information on the status of an application under the 2007 Hague Child Support Convention. Public reporting burden for this collection of information is estimated to average 0.33 hours per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a mandatory collection of information per 45 CFR 303.7. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. If you have any comments on this collection of information, please contact the ACF Reports Clearance Officer by email at infocollection@acf.hhs.gov.

¹ The Status of Application Report can be used for the purpose of Article 12(3), (4) and (5). If the Report is being used to provide updates, only include additional information that was not included in the previous reports.

3. Status of the application in the requested State

   1.  On (dd/mm/yyyy) the competent authority declared the decision enforceable or registered the decision for enforcement

( declaration or registration attached for information purposes only;

• applicant has been notified of the declaration or registration;

• applicant will be notified of the declaration or registration)

1.  On or by (dd/mm/yyyy) the competent authority is due to declare whether the decision is enforceable or is to be registered for enforcement

2.  On (dd/mm/yyyy) the respondent lodged a challenge or an appeal against the declaration or registration

3.  On (dd/mm/yyyy) the competent authority issued a decision refusing recognition and enforcement ( decision attached for information purposes only;  applicant has been notified of the decision;

   • applicant will be notified of the decision)

4.  On (dd/mm/yyyy) the competent authority refused recognition and enforcement as a result of a reservation under

Article 20(2). On (dd/mm/yyyy) a decision was established for the benefit of the creditor in accordance with

Article 20(4).

6.  On (dd/mm/yyyy) the respondent lodged a further appeal.

7.  On (dd/mm/yyyy) the application / decision was sent to the enforcement authority

8.  Application is still pending before the Central Authority

9.  Application / decision sent to enforcement authority and enforcement is impossible in the foreseeable future because:

   • Debtor without necessary resources

   • Debtor incarcerated

   • Other:

3.  The following steps have been taken (past):

   1.   Debtor /  creditor located

   2.  Voluntary payment secured (no enforcement measures were necessary)

   3.  Information concerning the financial circumstances of the debtor gathered

   4.  Assets of the debtor located

   5.  Enforcement and other measures initiated

      • Provisional measures

      • Wage withholding

      • Garnishment from bank account or other sources

      • Deductions from social security payments

      • Lien on or forced sale of property

      • Tax refund withholding

      • Withholding or attachment of pension benefits

      • Credit bureau reporting

      • Denial, suspension or revocation of licenses or passport

      • Mediation, conciliation or similar processes

      • Seizure of lottery or gambling winnings

      • Prohibition from leaving the requested State

      • Incarceration

      • Other:

   6.  Payments were secured (enforcement measures were necessary)

7.  Record of payments made by the debtor as of

(dd/mm/yyyy) attached

8.  Other:

3.  The following steps are being taken (present):

   1.  Locating the  debtor /  creditor

   2.  Securing voluntary payment (no enforcement measures are necessary)

   3.  Gathering of information concerning the financial circumstances of the debtor

   4.  Locating the assets of the debtor

   5.  Initiating enforcement measures

   6.  Securing payments (enforcement measures are necessary)

   7.  Other:

3.  The following steps will be taken (future):

   1.   Debtor /  creditor to be located

   2.  Voluntary payment to be sought (no enforcement measures will be necessary)

   3.  Information to be gathered concerning the financial circumstances of the debtor

   4.  Assets of the debtor to be located

   5.  Enforcement measures to be initiated

   6.  Payments to be sought (enforcement measures will be necessary)

   7.  Other:

3.  Please provide the following additional information and / or documentation:

3.  The application has been examined by the competent authority and is being returned because a declaration or registration has been refused on the ground that recognition and enforcement of the decision is manifestly incompatible with the public policy (“ordre public”) of the State addressed.²

3.  A challenge or an appeal has been lodged on the following grounds:

   1.  There are no bases for recognition and enforcement under Article 20

   2.  Recognition or enforcement of the decision is manifestly incompatible with the public policy ("ordre public") of the State addressed

   3.  The decision was obtained by fraud in connection with a matter of procedure

   4.  Proceedings between the same parties and having the same purpose are pending before an authority of the State addressed and those proceedings were the first to be instituted

   5.  The decision is incompatible with a decision rendered between the same parties and having the same purpose, either in the State addressed or in another State, and this latter decision fulfils the conditions necessary for recognition and enforcement in the State addressed

   6.  In a case where the respondent has neither appeared nor was represented in proceedings in the State of origin, the respondent had neither proper notice of the proceedings and an opportunity to be heard, nor proper notice of the decision and the opportunity to challenge or appeal it on fact and law

² This Section is limited to the ex officio review as provided under Article 23. Additional reasons should be added to this list for the purpose of the ex officio review under Article 24.

7.  The decision was made in violation of Article 18

8.  The authenticity or integrity of any document transmitted in accordance with Article 25(1) a), b) or d) or (3) b)

9.  The debt for past due payments has been fulfilled.

3.  The requested Central Authority has refused to process the application for the following reason(s):

   1.  Requesting Central Authority did not produce the additional documents or information within the period provided under Article 12(9)

   2.  Requirements of the Convention manifestly not fulfilled ( reasons attached)

Name: (in block letters) Date:

Authorised representative of the Central Authority (dd/mm/yyyy)