Organization Type. If you select Employer, provide the ▇▇▇▇▇ spreadsheet with information for your primary organization and any subsidiaries. If you select Third Party, provide the ▇▇▇▇▇ spreadsheet with client information including employers and subsidiaries. Organization Name: * Organization Known as Name (Doing Business As): Enter the employer or third-party provider’s address where child support agencies should mail paper NMSNs. Address Line 1: * Address Line 2: City: * State: * ZIP Code: * ZIP Code Extension: (Enter a five-digit ZIP code and the optional four-digit extension.) Is this also the address for mailing Income Withholding for Support Orders (IWOs)? Yes No Enter the organization’s business, technical support, and alternate contact information. Note: At least one person must be designated to received automated emails. Enter business contact information for working with OCSS to set up e-NMSN and assist with issue resolution. First Name: * MI: Last Name: * Email: * Send email notifications, including file processing information, to this email address. Phone Number: * Fax Number: (Enter numeric characters only. Include the area code. Format: 1231231111) (Enter numeric characters only. Include the area code. Format: ▇▇▇▇▇▇▇▇▇▇) Phone Ext:
Appears in 1 contract
Sources: Agreement to Exchange Electronic National Medical Support Notices
Organization Type. If you select Employer, provide the ▇▇▇▇▇ spreadsheet with information for your primary organization and any subsidiaries. If you select Third Party, provide the ▇▇▇▇▇ spreadsheet with client information including employers and subsidiaries. Organization Name: * Organization Known as Name (Doing Business As): Enter the employer or third-party provider’s address where child support agencies should mail paper NMSNs. Address Line 1: * Address Line 2: City: * State: * ZIP Code: * ZIP Code Extension: (Enter a five-digit ZIP code and the optional four-digit extension.) Is this also the address for mailing Income Withholding for Support Orders (IWOs)? Yes No Enter the organization’s business, technical support, and alternate contact information. Note: At least one person must be designated to received automated emails. Enter business contact information for working with OCSS OCSE to set up e-NMSN and assist with issue resolution. First Name: * MI: Last Name: * Email: * Send email notifications, including file processing information, to this email address. Phone Number: * Fax Number: (Enter numeric characters only. Include the area code. Format: 1231231111) (Enter numeric characters only. Include the area code. Format: ▇▇▇▇▇▇▇▇▇▇) Phone Ext:
Appears in 1 contract
Sources: Agreement to Exchange Electronic National Medical Support Notices