Form Part A - Revised 2 Part A - Revised 2 National Medical Support Notice Part A
National Medical Support Notice - Part A
2023 02 23 NMSN Part A Clean
National Medical Support Notice – Part A – Notice to Withhold for Health Care Coverage e-NMSN record specification layout Electronic system to system (Employer Respondents)
OMB: 0970-0222
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0970-0222 can be found here: