Form OCSE-75 Annual Report

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Form Approved
OMB No: 0970-0320
Expires://xxxx

Administration for Children and Families
Office of Child Support Enforcement

TRIBAL CHILD SUPPORT ENFORCEMENT ANNUAL DATA REPORT
(This report consists of one page)

TRIBE:

SUBMISSION: New 

Revised 

ITEMS

 NARRATIVE REPORT
Place X in box to confirm narrative report is attached.
TOTAL

SECTION A: CASE INVENTORY
1.

FISCAL YEAR:

Total Number of Cases Open at Any Time During the Fiscal Year
a.

Total Number of Open TANF Cases

b.

Total Number of Open Non-TANF Cases

2.

Total Number of Cases Open at Any Time During the Fiscal Year with
Support Order
SECTION B: PATERNITY ESTABLISHMENT
3.

Total Number of Children Ever Needing Paternity Established in Cases Open at Any
Time During the Fiscal Year
4. Total Number of Children With Paternity Concluded in Cases Open at Any Time
During the Fiscal Year
SECTION C: COLLECTIONS
5.

Total Amount of Current Support Due on Tribal Cases

6.

Total Amount of Current Support Collected on Tribal Cases

7.

Total Amount of Past Due Support Owed on Tribal Cases

8.

Total Amount of Past Due Collected on Tribal Cases

9.

Total Amount of All Support Collected During the Fiscal Year on All Cases

SECTION D: PROGRAM COST
10. Total Amount of Fees and Costs Recovered
11. Total Amount of Laboratory Costs for Paternity Establishment
SECTION E: OPTIONAL TRIBAL REPORTING
12. Total Amount Collected from Tribal Sources (Optional)
a. Percentage Collected
13. Tribal Unemployment Rate (Optional)
14. Tribal Joblessness Rate (Optional)
Paperwork Act Notice: Tribes are required to provide the information requested to receive a grant award under the provision of Title IV-D, Part 309 of the Social Security Act. This is public information.
The responses to this collection are mandatory. This information is not considered confidential, therefore, no additional safeguards are considered necessary beyond that customarily applied to routine
government information.
Reporting Burden Notice: Public reporting burden for this collection of information is estimated to average 60 hours per response, including the time for reviewing instructions, gathering and compiling
the data needed, and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently
valid OMB control number. Send comments regarding this burden estimate or any other aspect of this request for information, including suggestions for reducing this burden, to:
Reports Clearance Officer, Administration for Children and Families, Department of Health and Human Services, 330 C Street SW, Washington, DC 20201.
This is to certify the information provided on this report is accurate to the best of my
knowledge and belief.

Signature, Title IV-D Director or Other Official:

Agency Name:

Typed Name, Title:

Date:

FORM OCSE-75
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INSTRUCTIONS FOR COMPLETING FORM OCSE-75
TRIBAL CHILD SUPPORT ENFORCEMENT ANNUAL DATA REPORT
GENERAL REPORTING INSTRUCTIONS
Tribes use the OCSE-75 to report statistical and some financial information on their
Title IV-D Child Support Enforcement (CSE) program to the Department of Health and
Human Services (HHS). Information provided by the tribes allows HHS to report such
information in the Annual Report to Congress and will provide HHS with information on
tribal program performance. The authority to collect this information is set forth in
regulations at 45 CFR 309.170(b).
1. Submittal and Due Dates
The OCSE-75 report is completed by the tribal IV-D CSE program every Federal Fiscal
Year (FY) which begins October 1 and ends September 30. Tribal CSE Programs
must submit this report by December 29 of each year, which is 90 days after the end of
the FY through the Online Data Collection (OLDC) system. You are required to submit
your reports electronically by using OLDC.
2. Signature
The OCSE-75 must be signed and dated by the director of the tribe’s CSE Program or
by another appropriate official. For reporting on OLDC, the person who is designated
by the tribe to sign electronically will be assigned a special ID and password.
Approving the electronic OCSE-75 under these IDs and passwords indicates that the
appropriate person has reviewed and approved the report and is certifying that the
information is accurate, to the best of his or her knowledge.
3. Online Reporting
You are required to submit your reports electronically by using OLDC. The
Administration for Children and Families developed the OLDC system to allow tribes to
submit their OCSE-75 reports electronically through the HHS Website. The web
address for accessing the online system is: https://home.grantsolutions.gov/home/. For
GrantSolutions access, complete the Grantee User Account form found on the
GrantSolutions website. If you have any questions about the OCSE-75, contact the
Division of Performance and Statistical Analysis at DPSAsupport@acf.hhs.gov.

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4. Public Reporting
THE PAPERWORK REDUCTION ACT OF 1995
The public reporting burden for this collection of information is estimated to average
about 60 hours per response, including the time for reviewing instructions, gathering
and compiling the data needed, and reviewing the collection of information.
An agency may not conduct or sponsor, and a person is not required to respond to, a
collection of information unless it displays a currently valid OMB control number.
Send comments regarding this burden estimate or any other aspect of this request for
information, including suggestions for reducing this burden, to Reports Clearance
Officer, Administration for Children and Families, Department of Health and Human
Services, 330 C Street SW, Washington, DC 20201.
5. Narrative Reports
Tribal CSE Programs must submit a narrative report with the OCSE-75 on activities,
accomplishments, and progress, including success in reaching their performance
targets established by the tribe, or tribal organization. Please place an “X” in the the
box at the top of the form that reads “Narrative Report” to indicate the report is
attached.
Tribes are encouraged to provide OCSE with detailed information regarding the results
of their program operations in their narrative reports. Tribes are also asked to identify
the performance targets and discuss whether these targets were met for the reporting
FY.
Providing results statements and not just activities helps to provide more substantial
information for the Annual Report to Congress.
Examples:
1. Activity statement:
We sent 30 children for genetic testing.
2. Result statements:
a. We collected more than $20,000 in current support; a 5% increase over
last year.
b. We collected more than $440,000 in total support; a 7% increase over
last year.
c. Of 1,560 child support cases, 1,290 had a child support order established
(more than 80%).

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DEFINITIONS TO USE IN COMPLETING FORM OCSE-75
TRIBAL CHILD SUPPORT ENFORCEMENT ANNUAL DATA REPORT
The following definitions of terms are to be used in completing the OCSE-75. For
reporting purposes, these definitions have been modified and condensed. To obtain
definitions as they appeared in the regulations, please refer to section 309.05 of the
regulations. Definitions in 301.1 and 305.1 may also be helpful.
Case Inventory Definitions
1. Case 1 – A case where the parent (mother, father, alleged father, adoptive parents)
who is or may be obligated to support their child(ren) who are receiving services
under the Child Support Enforcement Program, either through referral from
Temporary Assistance for Needy Famlies (TANF), foster care, or Medicaid), where
the parent has filed an application for services, or intergovernmental cases.
2. TANF Case – A case where the child(ren) is/are currently receiving tribal or state
TANF.
3. Non-TANF Case – A case where the child(ren) formerly received tribal or state
TANF or a case where no assistance was provided. This includes Title IV-E federal
foster care cases, and Medicaid cases.
4. Child Support Order – The legal establishment of (1) an amount of money that is
due and owed by a parent for the support of the parent’s child(ren); and/or (2) the
responsiblility to provide health insurance and/or medical support for the child(ren).
5. Paternity – The legal establishment of fatherhood for a child, by tribal custom, court
determination, administrative process, or voluntary acknowledgment.
6. Tribal Case – Tribes may choose how they define a tribal case for purposes of
lines 5 through 8. Tribal cases may typically include cases where the child support
obligation is established by the tribe, but may also include foreign orders such as
those being enforced for tribal/community members. The methodology should be
consistent for reporting each line 5 through 8, and also consistent from year to year.

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These are cases receiving services under Title IV of the Social Security Act.

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SECTION A: CASE INVENTORY
Line 1 – Total Number of Cases Open At Any Time During The Fiscal Year
1. Report all cases that were open at any time during the FY that ends September
30. This includes counting any cases that were closed during the same FY.
2. Report cases the same way every year to be consistent. Report as a separate
case, each family with a dependent child(ren) that the parent is or may be
obligated to pay child support.
Examples:
a. A mother goes on tribal TANF and has two children from two different
fathers. How many cases would you count? You will count two cases,
one for each father.
b. A mother has two children from two different fathers and the children
were placed with relatives. One child went to live with Grandma and the
other one went to live with Aunty. How many cases will you count? You
will count four cases, one for each father and two for the mother.
3. Include in your case count any cases that were referred to your program by
another state, tribe or country.
4. Note that Line 1 is the total of Lines 1a and 1b (Line 1 = Lines 1a+1b)
Line 1a – Total Number of Open TANF Cases
1. Report the number of cases where the child(ren) received tribal or state TANF at
any time during the FY. This number includes any cases you may have closed
during that same FY.
Examples:
a. The FY is October 1 – September 30. A child received tribal TANF in
March and went off TANF in August. Would you count this as a TANF
case? Yes!
b. The FY is October 1 – September 30. A father went on state TANF with
three children three years ago and continues to be on TANF as of
September 30 of this year. Would you count this as a TANF case for this
year’s report? Yes!
2. Line 1a is a subset of Line 1.

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Line 1b – Total Number of Open Non-TANF Cases
1. Report the number of cases where the child(ren) formerly received tribal or
state TANF and where the child(ren) never received TANF. (Remember, don’t
count the case if the child(ren) were on TANF at any time during the same
reporting year.)
2. Report IV-E Foster Care and Medicaid-only cases as non-TANF cases.
3. If you are unsure if the child(ren) received TANF count this case as non-TANF.
Example:
The FY is October 1 – September 30. A child was on tribal TANF last FY
in August, but hasn’t been on TANF this FY. Would you count this as a
non-TANF case? Yes!
4. Line 1b is a subset of Line 1.
Line 2 – Total Number of Cases Open at Any Time During the Fiscal Year with a
Support Order
1. Report all cases that have a child support order open any time during the FY
that ends September 30. This includes counting any cases with a child support
order that were closed during the FY.
2. Include cases with orders for child support or medical support. Only count the
case once even if there are multiple orders on a case.
3. Include cases with orders that were established prior to the case coming to the
tribal program.
4. Include cases with a judgment for arrears.
5. Line 2 is a count of every case in the tribal caseload that has a support order,
not just a count of the support orders that the tribe established.
Example:
The tribe reported on Line 1 that there were 300 cases open at any time
during the FY. You have 200 cases where a support order has already
been established (such as foreign orders and support orders established
previous years). The tribe established 50 support orders this FY. How
many support orders do you have? Report 250 support orders on Line 2.
6. Line 2 is a subset of the total open cases in Line 1. Therefore, Line 2 can not be
more than Line 1.
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SECTION B: PATERNITY ESTABLISHMENT
Line 3 – Total Number of Children Ever Needing Paternity Established in Cases
Open at Any Time During the Fiscal Year
1. The tribe defines “children ever needing paternity established.”
2. Report all children who ever needed paternity established as defined by the
tribe, in the case load you reported on Line 1. Stated another way, “How many
children in the cases you reported on Line 1 ever needed paternity established?”
3. Paternity can only be counted once. Don’t count cases. Count children.
4. Report children who ever needed paternity established even if they are now
over 18.
Line 4 – Total Number of Children with Paternity Concluded
1. The tribes define “paternity concluded.” This term may include children whose
father has acknowledged or established paternity and cases where a tribe has
attempted to establish paternity but the alleged father was excluded and no
other alleged fathers are under the tribe’s jurisdiction.
2. You should report all children where the case was open at any time during the
FY, which ends September 30, where paternity was concluded. This includes
counting any children where the cases were closed during the same FY.
3. Paternity can only be counted once. Don’t count cases. Count children.
4. Report children where paternity was concluded by the tribe or by another
jurisdiction.
5. Report children where paternity was concluded even if they are now over 18.
6. Line 4 is a subset of Line 3. Line 4 can not be more than Line 3.
SECTION C: COLLECTIONS
Line 5 – Total Amount of Current Support Due on Tribal Cases
1. Report the Total amount of current support due on tribal cases during the FY.
2. Tribes may choose how they define a tribal case for purposes of Lines 5 through
8.

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3. Tribal cases will typically include cases where the child support obligation is
established by the tribe but may also include foreign orders such as those being
enforced for tribal/community members.
4. The methodology should be consistent for reporting each Line 5 through Line 8
and also be consistent from year to year.
5. Include voluntary collections as amount due (voluntary collections are those
made without a support order or payments made that exceeded the ordered
amount where no arrears are due).
6. Remember to include amounts due for the months that the case was open
during the FY, even if the case closed during the FY.
7. These amounts may be computed monthly and the total of all months reported
at the end of the FY (September 30).
Example:
A parent’s child support obligation is $100 per month, and the case was
open for all 12 months of this FY. You would report $1,200 for current
support due (12 months x $100).
Line 6 – Total Amount of Current Support Collected on Tribal Cases
1. Report the Total amount of current support collected on tribal cases during the
FY. (See definition above).
Example:
A parent’s current child support obligation is $100 per month ($1,200 for the
FY). He paid $1,000 in current support during the reporting FY. The amount
of current support collected is $1,000.
2. Include voluntary collections as amount due (voluntary collections are those
made without a support order or payments made that exceeded the ordered
amount where no arrears are due).
3. These amounts may be computed monthly and the total of all months reported
at the end of the FY (September 30).
4. Line 6 is a subset of Line 5.
Line 7 – Total Amount of Past-Due Support Owed on Tribal Cases
1. Report the total amount of all past-due support owed on those tribal cases that
are opened as of September 30.
2. Interest, if charged, may be included in the amount.
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Examples:
a. A parent’s child support obligation is $1,000 per month ($12,000 for the
FY). He paid $2,000 in current support this reporting FY, and he did not
owe any past-due support from prior FYs. The amount of past-due
support owed is $10,000 ($12,000-$2,000) for this FY.
b. The FY is October 1 – September 30. A parent owes $20,000 from last
FY. The parent paid the full amount of current support every month this
FY. Report past-due support of $20,000 on the report for this FY.
Line 8 – Total Amount of Past-Due Support Collected on Tribal Cases
1. Report the total amount of past-due support collected on tribal cases during the
FY.
2. Line 8 is a subset of Line 7.
Example:
The FY is October 1-September 30. A parent owed $20,000 last FY.
The parent paid current support every month and paid an additional
amount of $250 toward his past support. The amount of past due
collected is $3,000 ($250 x 12 months).
Line 9 – Total Amount of All Support Collected During the Fiscal Year on All
Cases
1. Report the total amount of current and past due support collected on ALL cases
as of the end of the FY (September 30).
2. This includes all collections on all support cases reported on Line 1, not just
tribal cases.
SECTION D: PROGRAM COST
Line 10 – Total Amount of Fees and Cost Recovered
1. Report the total amount of fees and costs obtained by the Program during the
FY that are used to offset administrative costs.
2. Count all mandatory or optional fees collected from recipients of child support
services such as application fee or collection fee, not inconsistent with Federal
law.
3. Do not include fees for laboratory paternity testing (these fees are included with
the entry on Line 11).
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Line 11 – Total Amount of Laboratory Cost for Paternity Established
1. Report the total amount of laboratory costs associated with the process of
determining paternity that was paid in that FY.
2. The entry on this line will be the “net” amount of expenditures, reduced by any
fees collected by the tribe to recoup the cost of these services.
SECTION E: OPTIONAL TRIBAL REPORTING
Line 12 – Total Amount Collected From Tribal Sources (Optional)
1. Report collections that the tribe obtained from tribal sources as defined by the
tribe that were collected during the FY, which ends September 30.
2. This is an optional reporting element.
Line 12a – Percentage Collected from Tribal Sources (Optional)
1. Report the percentage collected from tribal sources by dividing Line 12 by Line 9
(total current and past due collected).
2. This is an optional reporting element.
Line 13 – Tribal Unemployment Rate (Optional)
This is an optional reporting line, and may be obtained from an actual study or report
such as the Bureau of Indian Affairs (BIA) Labor Force Report, or other Tribal
calculations based on tribal members, tribal child support caseload, or other
appropriate group.
Line 14 – Tribal Joblessness Rate (Optional)
This is an optional reporting line.

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