# Agency Information Collection Activities: Submission for OMB Review: Comment Request
Periodically, the Health Resources and Services Administration (HRSA) publishes abstracts of information collection requests under review by the Office of Management and Budget (OMB), in compliance with the Paperwork Reduction Act of 1995 (44 U.S.C. Chapter 35). To request a copy of the clearance requests submitted to OMB for review, e-mail *[email protected]* or call the HRSA Reports Clearance Office on (301) 443-1129.
The following request has been submitted to the Office of Management and Budget for review under the Paperwork Reduction Act of 1995:
**Proposed Project: Application for Certification and Recertification as a Federally Qualified Health Center (FQHC) Look-Alike (OMB No. 0915-0142): Revision**
The Health Resources and Services Administration (HRSA) collects applicant information for organizations applying for certification or recertification as a Federally Qualified Health Center (FQHC) Look-Alike for purposes of cost-based reimbursement under the Medicaid and Medicare programs. The information contained in the application guidance reflects legislative, policy, and technical requirements for applicant organizations.
The estimated burden is as follows:
| Instrument | Number of | Responses per | Hours per | Total burden hours |
| --- | --- | --- | --- | --- |
| Application | 40 | 1 | 100 | 4,000 |
| Recertification | 100 | 1 | 15 | 1,500 |
| Total | 140 | | | 5,500 |
Written comments and recommendations concerning the proposed information collection should be sent within 30 days of this notice to the desk officer for HRSA, either by e-mail to *[email protected]* or by fax to 202-395-6974. Please direct all correspondence to the “attention of the desk officer for HRSA.”
Dated: September 30, 2008.
Alexandra Huttinger,
Director, Division of Policy Review and Coordination.