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Form 1 MSFIDM Election Form
Multistate Financial Institution Data Match and Federally Assisted State Transmitted Levy (MSFIDM/FAST Levy)
MSFIDM Electronic_Election Form_032224
Election Form
OMB: 0970-0196
OMB.report
HHS/ACF
OMB 0970-0196
ICR 202403-0970-015
IC 10015
Form 1 MSFIDM Election Form
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0970-0196 can be found here:
2024-12-20 - No material or nonsubstantive change to a currently approved collection
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