Information Collection Request

National Medical Support Notice - Part A

ICR 202504-0970-026 · OMB 0970-0222 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 National Medical Support Notice Part A Form Modified Available
Form 1 National Medical Support Notice Part A Form Modified Available
Form NMSN Matrix State Medical Support Contacts and Program Requirement Matrix Form Unchanged Available
Form NMSN Matrix State Medical Support Contacts and Program Requirement Matrix (State Respondents) Form Unchanged Repair queued
Form 1 National Medical Support Notice Part A Form Modified Available
Form 1 National Medical Support Notice Part A Form Modified Available
NonSub Change - Update to ACF ICs - Protecting Women and DEI EOs - 04.25.2025.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-04-24 Repair queued
NonSub Change - Update to ACF ICs - Protecting Women and DEI EOs - 04.25.2025.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-04-24 Missing upstream
2023 e-NMSN record specifications-NMSN Part A_NonSub Change Request_1.2.24.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-01-02 Available
2023 e-NMSN record specifications-NMSN Part A_NonSub Change Request_1.2.24.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-01-02 Repair queued
NMSN Part A _NonSub Change Request_nc_3-2-23.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-03-02 Repair queued
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 Repair queued
NonSub Change Request - MNSN Updates 0970-0222.docx Justification for No Material/Nonsubstantive Change Uploaded 2022-11-23 Repair queued
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
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 Repair queued
Attachment A - Public Comments Received on the National Medical Support Notice Part A_final.docx Supplementary Document Uploaded 2022-09-16 Available
Attachment A - Public Comments Received on the National Medical Support Notice Part A_final.docx Supplementary Document Uploaded 2022-09-16 Repair queued
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
2022 10 27 NMSN_Part_A_Sample_Form_after 30 day comment period clean Final to NC.docx Supplementary Document Uploaded 2022-11-23 Missing upstream
NMSN Part A Supporting Statement _NonSub Chg - eNMSN_1.2.24.docx Supporting Statement A Uploaded 2024-01-02 Available
NMSN Part A Supporting Statement _NonSub Chg - eNMSN_1.2.24.docx Supporting Statement A Uploaded 2024-01-02 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
264137 National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (Employer Respondents) Form ModifiedNational Medical Support Notice Part A
264137 National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (Employer Respondents) Instruction Modified
264134 National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (State Respondents) Form ModifiedNational Medical Support Notice Part A
264134 National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (State Respondents) Instruction Modified
255976 State Medical Support Contacts and Program Requirement Matrix (State Respondents) Form UnchangedState Medical Support Contacts and Program Requirement Matrix
255976 State Medical Support Contacts and Program Requirement Matrix (State Respondents) Form Unchanged
236881 National Medical Support Notice-Part A (Employer Respondents) Form ModifiedNational Medical Support Notice Part A
236881 National Medical Support Notice-Part A (Employer Respondents) Instruction Modified
10060 National Medical Support Notice-Part A (State Respondents) Form ModifiedNational Medical Support Notice Part A
10060 National Medical Support Notice-Part A (State Respondents) Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
11/30/2025 11/30/2025 11/30/2025
9,771,527 0 9,771,527
1,657,190 0 1,657,190
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 9,771,527 9,771,527 0 0 0 0
Annual Time Burden (Hours) 1,657,190 1,657,190 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No