e-NMSN Agreement and Profile Forms

OMB 0970-0370

Publication Date: July 21, 2022
Current as of:

e-NMSN Employer Agreement and Profile Form

Employers and third party processors must complete this OMB-approved employer form (PDF) and the template for the organization's multiple FEINs to register to use the e-NMSN process.

e-NMSN Plan Administrator Agreement and Profile Form

Plan Administrators must complete this OMB-approved plan administrator form (PDF) and the template for the organization's multiple FEINs to register to use e-NMSN.

Employers can contact the Employer Services Team for more information about the process and forms.