# Agency Information Collection Activities; Submission to OMB for Review and Approval; Public Comment Request
**AGENCY:**
Office of the Secretary, HHS.
**ACTION:**
Notice.
**SUMMARY:**
In compliance with section 3507(a)(1)(D) of the Paperwork Reduction Act of 1995, the Office of the Secretary (OS), Department of Health and Human Services, has submitted an Information Collection Request (ICR), described below, to the Office of Management and Budget (OMB) for review and approval. The ICR is for renewal of the approved information collection assigned OMB control number 0990-0001, scheduled to expire on September 30, 2013. Comments submitted during the first public review of this ICR will be provided to OMB. OMB will accept further comments from the public on this ICR during the review and approval period.
**DATES:**
Comments on the ICR must be received on or before September 9, 2013.
**ADDRESSES:**
Submit your comments to *[email protected]* or via facsimile to (202) 395-5806.
**FOR FURTHER INFORMATION CONTACT:**
Information Collection Clearance staff, *[email protected]* or (202) 690-6162.
**SUPPLEMENTARY INFORMATION:**
When submitting comments or requesting information, please include the OMB control number 0990-0001 and document identifier HHS-OS-19201-30D for reference.
*Information Collection Request Title:* Application for waiver of the two year foreign residence requirement of the Exchange Visitor Program.
*OMB No.:* 0990-0001
*Abstract:* The HHS program deals with both research and clinical care waivers. Applicant institutions apply to this Department to request a waiver on behalf of research scientists or foreign medical graduates to work as clinicians in HHS designated health shortage areas doing primary care in medical facilities. The instructions request a copy of Form G-28 from applicant institutions represented by legal counsel outside of the applying institution. United States Department of Justice Form G-28 ascertains that legal counsel represents both the applicant organization and the exchange visitor.
*Need and Proposed Use of the Information:* Required as part of the application process to collect basic information such as name, address, family status, sponsor and current visa information.
*Likely Respondents:* Research scientists and research facilities.
*Burden Statement:* Burden in this context means the time expended by persons to generate, maintain, retain, disclose or provide the information requested. This includes the time needed to review instructions, to develop, acquire, install and utilize technology and systems for the purpose of collecting, validating and verifying information, processing and maintaining information, and disclosing and providing information, to train personnel and to be able to respond to a collection of information, to search data sources, to complete and review the collection of information, and to transmit or otherwise disclose the information. The total annual burden hours estimated for this ICR are summarized in the table below.
| Type of respondent | Form name | Number of | Number of | Average | Total burden hours |
| --- | --- | --- | --- | --- | --- |
| Application Waiver/Supplemental A Research | HHS 426 | 45 | 1 | 10 | 450 |
| Application Waiver/Supplemental B Clinical Care | HHS 426 | 35 | 1 | 10 | 350 |
| Total | | | | | 800 |
Darius Taylor,
Deputy, Information Collection Clearance Officer.