Application of Waiver of the 2 Year Foreign Residence Requirement of the Exchange Visitor Program

Forms and Documents

Document Name	Status
Form 426 Application Waiver/ Supplemental- Clinical Care Form	Modified
Form 426 ApplicationsWaiver/ Supplemental A- Research Form	Modified
OMB 0990-0001 Change Reques.doc Justification for No Material/Nonsubstantive Change	2010-11-19

IC Document Collections

IC ID	Document Title	Status
46706	Application Waiver/ Supplemental- Clinical Care Form	Modified
10278	ApplicationsWaiver/ Supplemental A- Research Form	Modified

ICR Details

OMB Control No: 0990-0001	ICR Reference No: 201011-0990-008
Status: Historical Active	Previous ICR Reference No: 201007-0990-001
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: Application of Waiver of the 2 Year Foreign Residence Requirement of the Exchange Visitor Program
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/29/2010
	Date Received in OIRA: 11/23/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2013	09/30/2013	09/30/2013
Responses	250	0	250
Time Burden (Hours)	2,500	0	2,500
Cost Burden (Dollars)	25,000	0	25,000

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Abstract: The information requred by use of this form and supplementary information sheets is used by this Department to make a determination, in accordance with its published regulations, as to whether or not to request from the Department of State, a waiver of the two-year foreign residence requirement for applicants in the United States on a J-1 visa.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
ApplicationsWaiver/ Supplemental A- Research	426, 426	Application ,   Application
Application Waiver/ Supplemental- Clinical Care	426, 426	Application Waiver ,   Application

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	250	250	0	0	0	0
Annual Time Burden (Hours)	2,500	2,500	0	0	0	0
Annual Cost Burden (Dollars)	25,000	25,000	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $714,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 11/23/2010

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