I am writing on behalf of the state IV-D Directors to request your assistance with an issue regarding the National Medical Support Notice (NMSN). As states have begun to use the NMSN it has become apparent that the NMSN is too lengthy and extremely costly to issue repeatedly to the same employers and plan administrators. If we could find alternative methods to provide employers and plan administrators with NMSN instructions (e.g. using brochures, internet, etc.) it would make the issuance of the NMSN more efficient. In addition, employer and plan administrators would be pleased to receive less paper. Could we please explore alternatives to reduce the length of the NMSN while providing the necessary instructions in a different format? Thank you for your consideration of this issue.