National Medical Support Notice

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form Part A National Medical Support Notice Form
Part A National Medical Support Notice NMSN Part A - DRAFT FORM 11292007.doc Form
NMSN Part A - List of Changes to Form 11162007.doc Revisions IC Document
NMSN Part A - TRACKED FORM 11292007.doc Revisions IC Document
NMSN Part A - Comments & Responses 11292007.doc Comments IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	National Medical Support Notice	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Part A	National Medical Support Notice	NMSN Part A - DRAFT FORM 11292007.doc		No	No	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 54	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	726,516	0	726,516
Annual IC Time Burden (Hours)	123,508	1	123,507
Annual IC Cost Burden (Dollars)	0	-11,000	11,000

Documents for IC

Title	Document	Date Uploaded
Revisions	NMSN Part A - List of Changes to Form 11162007.doc	12/10/2007
Revisions	NMSN Part A - TRACKED FORM 11292007.doc	12/10/2007
Comments	NMSN Part A - Comments & Responses 11292007.doc	12/10/2007

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.