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Federal forms, ICRs, and supporting documents

Information Collection

National Medical Support Notice-Part A (State Respondents)

IC 10060 under ICR 202209-0970-007 · OMB 0970-0222.

Documents and Forms
Document Name
Document Type
Form
Instruction
Instruction
Form
Form
Form and Instruction
Form and Instruction
Information Collection (IC) Details

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National Medical Support Notice-Part A (State Respondents)
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form Part A - Revised 2022 National Medical Support Notice - Part A OMB_0970_0222_PartA_11042019_Final.docx Yes Yes Fillable Printable
Instruction 2022 07 22 NMSN_Instructions_Part_A clean.docx Yes Yes Printable Only
Form and Instruction Part A - 2019 Version National Medical Support Notice Part A (2019) OMB_0970_0222_PartA_11042019_Final.docx Yes Yes Fillable Fileable

Community and Social Services Social Services

 

54 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 4,870,476 0 30,240 0 0 4,840,236
Annual IC Time Burden (Hours) 827,981 0 5,141 0 0 822,840
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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