Request for Customer Number Data Change

Representative and Address Provisions

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0651-0035 can be found here:

Documents and Forms

Document Name Document Type
Form PTO/SB/124 Request for Customer Number Data Change Form
PTO/SB/124 Request for Customer Number Data Change sb0124-fill.pdf www.uspto.gov/web/forms/sb0124-fill.pdf Form

Information Collection (IC) Details

IC Title:	Request for Customer Number Data Change	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 37 CFR 1.32 and 1.33

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	PTO/SB/124	Request for Customer Number Data Change	sb0124-fill.pdf	http://www.uspto.gov/web/forms/sb0124-fill.pdf	Yes	Yes	Fillable Fileable Signable

Line of Business: Economic Development

Subfunction: Intellectual Property Protection

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,400	Number of Respondents for Small Entity: 600

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,400	2,400
Annual IC Time Burden (Hours)	480	480
Annual IC Cost Burden (Dollars)	211	211

Documents for IC

Title	Document	Date Uploaded
No associated records found

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