SFN 443, Notice of Right to Claim 'Good Cause' 400-19-165-75

(Revised 5/1/2023 ML #3704)

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SFN 443, "Notice of Right to Claim 'Good Cause,'" is used to inform TANF applicants of their right under Section 208 of Public Law 94-88 to claim an exemption from the requirement to cooperate with the child support enforcement effort if they believe that by doing so they would be acting contrary to the best interests of their child(ren). The form must be given to all TANF custodians as part of the application process or when a custodian included in the open case adds a child into the case and the custodian has not already signed an SFN 443. The notice briefly summarizes the legislative intent of child support enforcement and the applicant's obligation to cooperate in the support collection effort and describes the circumstances under which cooperation may be "against the best interests" of the child(ren) and provides examples of the kinds of evidence necessary to substantiate a claim of good cause.

 

The applicant should be allowed sufficient time to read the notice, ask questions, and sign and date the document.

 

The signed and dated original notice shall be filed in the applicant's case record as documentation that the notice was in fact received. The canary-colored copy shall be given to the applicant.

 

This form is available through the Department of Human Services and may also be obtained electronically via E-Forms. (34kb pdf)

 

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