Public Chapter 427 was signed into law on May 18, 2017 and required the Tennessee Commission on Aging and Disability to work with several specific state agencies and other stakeholders to review the current system of public guardianship, active since 1986, in Tennessee. D. The Child Support office has the Social Security number (SSN) of the alternate residential parent (ARP). • You must notify us immediately if you move or change your telephone number. Read the undertaking carefully and proceed with signing at the bottom in acceptance of the undertaking followed by entering the date to complete and submit form HS-2912, Application For Child Support Services to the Department of Human Services, State of Tennessee. Mother __________ Father __________ Both _________ Neither __________, Carrier name (excluding TennCare): ___________________________________________________________________________________________, Policy number: ____________________________________________ Insured’s name: _____________________________________________, Monthly insurance premium: _________________________________ Number of family members covered by policy: _____________________, Name(s) of the child(ren) who are covered by this policy, _________________________________________________________ ______________________________________________________, Do the child(ren) have any unpaid medical bills? D. The State has the right to withhold amounts from future IRS offsets if I do not voluntarily repay amounts paid to me in error. C. The alternate residential parent (ARP) must owe at least $500.00 past due child support under such order. A filing fee is required at the time of filing. Attach additional sheets if needed. Select between yes or no to state whether the child’s parents were married at the time of the birth of the child. Child’s Last Name _____________________ First Name _______________________ Middle Name ____________, Social Security Number: ___________________________________ Date of Birth: ______________________________, City / County / State of Birth: _____________________________________________________________________________, a. What is an emergency custody (temporary) order? Child’s Last Name _____________________ First Name _______________________ Middle Name ____________, 5. If I get any money as the result of fraud on my part, I understand that the State may charge me with fraud. Notice of the continued hearing will be given to the incompetent. Kid Central is a one-stop shop for Tennessee families to connect with important information and resources provided by Tennessee state departments. custody of the child or children named above.post-judgment modification of custody. Specify the relationship of caretaker with the child. Child’s Last Name _____________________ First Name _______________________ Middle Name ____________, I, ____________________________, am applying for Child Support services provided by the Child Support Agency of the Tennessee. Yes __ No __ (If yes, provide itemized detail and copies of all bills. An emergency custody order would put an order in place immediately without providing notice to the other party. ... II need a petition for ex parte emergency temporary custody form where can I find one online for Tennessee so I can print off. Mention the Social Security Number/s of all individuals related to the child. It is possible that your SSN and those of the child(ren) will be used to file interstate child support, enforcement actions and to enroll the child(ren) as beneficiaries of health insurance coverage, and, as such, may be released to the other, parent. There is no guarantee that money will be collected on my behalf. A magistrate uses the following forms for emergency custody or temporary detention for mental health evaluation and care: MAGISTRATE MANUAL EMERGENCY CUSTODY AND TEMPORARY DETENTION ORDERS PAGE 6-3 Office of the Executive Secretary Department of Magistrate Services Rev: 7/20 1. Furnish the date/duration of service and branch if ARP served in armed forces. Furnish the information of alternate contact person’s name, phone number, and relationship in case you are not reachable for child support service. Enter home, work and cell phone numbers of ARP in the spaces provided for the same along with the area code as applicable. 5. Mention the nature of the benefit you are receiving if any along with the duration and name of the state if other than Tennessee. Select yes or no to confirm if the paternity established when the child born out of wedlock. Tennessee Guardian of Minor Power of Attorney Form is a limited legal document utilized by the parent(s) or guardian(s) only to be used upon an event that is specified: for example, an extended hospital stay, serious illness, temporary … Chapter 1 - Guardianships and Conservatorships Generally ; Chapter 2 - Guardianship Generally ; Chapter 3 - Conservatorship Generally ; Chapter 4 - Estates of Incompetents [Repealed] Chapter 5 - Uniform Veterans' Guardianship … Furnish details of assets held by ARP. I understand and acknowledge the following: 1. 8. Mark your choice yes for the court order if any. Leave blank if you select no. B. Child’s Last Name _____________________ First Name _______________________ Middle Name ____________, 3. annulment. In those cases, the objective allows a parent to flee an abusive situation and seek emergency temporary custody either within the state having jurisdiction or another state. Furnish the names of child(ren) covered under the policy. Over a year ago now, the mother of my child gave her parents temporary custody. Tick mark in the appropriate box. information about yourself in Section III. 14. Has the primary residential parent (PRP) / caretaker ever been married to the alternate residential parent (ARP)? This temporarily grants one parent or another party sole physical and legal custody of the child in question. You can search our library of over 700,000 free legal documents to find the legal form that is right for your legal needs. Specify the source of income and approximate income from each source in the subsequent lines. How do I get an emergency custody order for my child? Specify the name and address of the institution along with the expected release date if ARP is in jail or prison. Filling details in the respective fields is necessary. You must complete, date and sign the Petition for Emergency Custody, as follows. If the child(ren) in this case receive Medicaid or TennCare, I must tell the Child Support office immediately. You can attach a separate sheet if needed for furnishing additional information. What is the alternate residential parent (ARP)’s relationship to the child(ren)? Based on section 466(a)(13) of the Social, Security Act [42 U.S.C. Child’s Last Name _____________________ First Name _______________________ Middle Name ____________, INFORMATION ABOUT THE CHILDREN (continued), 4. I must repay to the State any money that I am overpaid, or that is sent to me in error. I ask the Court to enter the following ex parte orders: Temporary custody to. Yes No, If yes, for what period of time? Describe any assets the alternate residential parent (ARP) may own. They will be used by. Enter your name in the space provided on line 1 of the application. 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