Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (Employer Respondents) - 2026 Forward New 93 1 0 Instruction
Instruction
Form 1 National Medical Support Notice Part A
Instruction
National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (Employer Respondents) - Implementation Year Modified 93 1 0 Instruction
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Instruction
Form 1 National Medical Support Notice Part A
National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (State Respondents) - 2026 Forward New 35000 350 0 Instruction
Instruction
Form 1 National Medical Support Notice Part A
Instruction
National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (State Respondents) - Implementation Year Modified 25000 250 0 Instruction
Instruction
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Form 1 National Medical Support Notice Part A
National Medical Support Notice-Part A (Employer Respondents) - 2026 Forward New 4686721 796742 0 Instruction
Form 1 National Medical Support Notice Part A
Instruction
National Medical Support Notice-Part A (Employer Respondents) - Implementation Year Modified 4875904 828904 0 Instruction
Form 1 National Medical Support Notice Part A
National Medical Support Notice-Part A (State Respondents) - 2026 Forward New 4688172 796989 0 Instruction
Form 1 National Medical Support Notice Part A
Instruction
National Medical Support Notice-Part A (State Respondents) - Implementation Year Modified 4870476 827981 0 Instruction
Form 1 National Medical Support Notice Part A
State Medical Support Contacts and Program Requirement Matrix (State Respondents) - Implementation Year Modified 54 54 0 Form NMSN Matrix State Medical Support Contacts and Program Requirement Matrix
Total burden requested under this ICR: 19181513 3251272 0  
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