Information Collection Request

National Medical Support Notice - Part A

ICR 202302-0970-005 · OMB 0970-0222 · Active

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0970-0222 can be found here:

Forms and Documents

Forms and supporting documents for this ICR
Document	Type	Status	Availability
Form NMSN Matrix State Medical Support Contacts and Program Requirement Matrix (State Respondents)	Form	Unchanged	Available
Form Part A - Revised 2 National Medical Support Notice-Part A (Employer Respondents)	Form	Modified	Available
Form Part A - Revised 2 National Medical Support Notice-Part A (State Respondents)	Form	Modified	Available
NMSN Part A _NonSub Change Request_nc_3-2-23.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-03-02	Repair queued
NonSub Change Request - MNSN Updates 0970-0222.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-11-23	Available
2022 10 27 Public Comments Received on the National Medical Support Notice Part A after 30 day comment period Responses Final for NC.docx	Supplementary Document	Uploaded 2022-11-23	Available
Attachment A - Public Comments Received on the National Medical Support Notice Part A_final.docx	Supplementary Document	Uploaded 2022-09-16	Available
2022 10 27 NMSN_Part_A_Sample_Form_after 30 day comment period clean Final to NC.docx	Supplementary Document	Uploaded 2022-11-23	Available
NMSN Part A Supporting Statement _9.15.22_final.docx	Supporting Statement A	Uploaded 2022-09-16	Available

Information collection document groups
IC ID	Collection	Type	Status
255976	State Medical Support Contacts and Program Requirement Matrix (State Respondents)	Form	Unchanged
236881	National Medical Support Notice-Part A (Employer Respondents)	Form	Modified
10060	National Medical Support Notice-Part A (State Respondents)	Form	Modified

Record metadata
Status	Active
Agency/Subagency	HHS/ACF
OMB Control No	0970-0222
Type of Information Collection	No material or nonsubstantive change to a currently approved collection
Previous ICR Reference No	202211-0970-008
Agency Tracking No	OCSE
Date Submitted to OIRA	2023-03-03
Requested Expiration Date	1969-12-31