Information Collection

Application for a Patent License

IC 27957 under ICR 200612-2700-003 · OMB 2700-0039.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2700-0039 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Supporting Statement 2700-0039 (2).doc Supporting Statement	IC Document
E6-16854.pdf Agency Federal Register Notice	IC Document
83-I 2700-0039.pdf Submission Form	IC Document

IC Title:

Application for a Patent License

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 37 CFR 501 37 CFR 404

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: General Science and Innovation

Subfunction: Space Exploration and Innovation

Privacy Act System of Records

Title: None

FR Citation: 71 FR 197

Number of Respondents: 60

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	60	-25	85
Annual IC Time Burden (Hours)	600	-80	680
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement	Supporting Statement 2700-0039 (2).doc	12/21/2006
Agency Federal Register Notice	E6-16854.pdf	12/21/2006
Submission Form	83-I 2700-0039.pdf	12/21/2006

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.