Clearance for the Collection of Qualitative Feedback

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form G264-2 Attendee Survey	Form	New	Available
Form G264-1 Exhibitor Survey	Form	New	Available
Form G263-1 STEPP Interest Form	Form	New	Repair queued
Form G260-1 Customer Satisfaction Survey	Form	New	Available
Form G261-1 Pro Bono Survey Questions	Form and Instruction	New	Available
Form G259-1 P3 Survey Questions	Form	New	Available
Form G258-1 Survey Questions	Form	New	Available
Form G257-1 External Engagement Survey	Form	New	Available
Form G255-3 STEPP PIlot Interest Form	Form	New	Repair queued
Form G255-2 STEPP Needs Assessment Survey	Form	New	Available
Form G255-1 STEPP Evaluation	Form	New	Available
Form G254-4 System Usability Scale	Form	New	Available
Form G254-3 Participant Scenario Worksheet	Form	New	Available
Form G254-2 Background Information	Form and Instruction	New	Repair queued
Form G254-1 Audio/Video Consent Form	Form	New	Available
Form G253-2 Background Information	Form and Instruction	New	Available
Form G253-1 Audio/Video Consent Form	Form	New	Available
Form G252-2 Background Information	Form and Instruction	New	Available
Form G252-1 Audio/Video Consent Form	Form	New	Available
Form G246 Pro Se Feedback Questions	Form and Instruction	New	Available
Form G248 PatentsView Query Tool Questionnaire	Form	New	Repair queued
Form G245 -1 Private Sector Survey	Form	New	Available
Form G220-04 Dallas Open House Regristration	Form	New	Available
Form G220-03 Road Show Registration	Form	New	Available
Form G220-02 Dallas IP info sessions	Form	New	Available
Form G220-01 TX Road Show Survey 2015	Form	New	Available
Fast Track Requests Info and Form.docx	Supplementary Document	Uploaded 2015-06-25	Available
0651-USPTO-InfoQuality-Guidelines-01_07_2013.pdf	Supplementary Document	Uploaded 2015-06-25	Available
0038 Generic Clearance Supporting Statement Sect. B.doc	Supporting Statement B	Uploaded 2015-06-25	Available
0651 Generic Clearance Supporting Statment June 2015.doc	Supporting Statement A	Uploaded 2015-06-25	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
224464	G267- HR Employee Relations Survey	Other-Survey	New
224361	G265- Global Dossier Survey and Focus Group	Other-Survey	New
224154	G262 IP Education Outreach Council Events	Other-Survey	New
223953	G264: 2016 USPTO Trademark Expo Surveys	Form	New	Attendee Survey
223953	G264: 2016 USPTO Trademark Expo Surveys	Form	New	Exhibitor Survey
223044	G263 STEPP Interest Form	Form	New	STEPP Interest Form
222956	G260: Electronic Business Center Survey	Form	New	Customer Satisfaction Survey
222671	G261 Patents Pro Bono Metrics Survey	Form and Instruction	New	Pro Bono Survey Questions
222599	G259 Post Prosecution Pilot Program (P3)	Form	New	P3 Survey Questions
221905	G258-Dallas and San Jose Recruitment Outreach	Form	New	Survey Questions
221900	G257- PTAB E2E System Survey and Focus Group	Form	New	External Engagement Survey
221900	G257- PTAB E2E System Survey and Focus Group	Instruction	New
221214	G255 STEPP Pilot Program Surveys	Form	New	STEPP PIlot Interest Form
221214	G255 STEPP Pilot Program Surveys	Form	New	STEPP Needs Assessment Survey
221214	G255 STEPP Pilot Program Surveys	Form	New	STEPP Evaluation
221150	G254 Usability Testing Feedback in Support of Next Generation Initiatives	Form	New	System Usability Scale
221150	G254 Usability Testing Feedback in Support of Next Generation Initiatives	Form	New	Participant Scenario Worksheet
221150	G254 Usability Testing Feedback in Support of Next Generation Initiatives	Form and Instruction	New	Background Information
221150	G254 Usability Testing Feedback in Support of Next Generation Initiatives	Form	New	Audio/Video Consent Form
221150	G254 Usability Testing Feedback in Support of Next Generation Initiatives	Instruction	New
221147	G253 Small Discussion Group Feedback in Support of Next Generation Initiatives	Form and Instruction	New	Background Information
221147	G253 Small Discussion Group Feedback in Support of Next Generation Initiatives	Form	New	Audio/Video Consent Form
221147	G253 Small Discussion Group Feedback in Support of Next Generation Initiatives	Instruction	New
221146	G252 Focus Group Feedback in Support of Next Generation Initiatives	Form and Instruction	New	Background Information
221146	G252 Focus Group Feedback in Support of Next Generation Initiatives	Form	New	Audio/Video Consent Form
221146	G252 Focus Group Feedback in Support of Next Generation Initiatives	Instruction	New
220562	G250: Global Patent Prosecution Focus Group	Instruction	New
220348	G249: Patents Recruitment Open House	Other-Survey	New
220200	G246: Pro Se Education and Customer Service Feedback	Form and Instruction	New	Pro Se Feedback Questions
220121	G248 PatentsView Query Tool Usability Testing	Form	New	PatentsView Query Tool Questionnaire
219216	G245: LSAC Events	Form	New	Private Sector Survey
219216	G245: LSAC Events	Other-Focus group script	New
218140	Texas Patents Recruitment Roadshow	Form	New	Dallas Open House Regristration
218140	Texas Patents Recruitment Roadshow	Form	New	Road Show Registration
218140	Texas Patents Recruitment Roadshow	Form	New	Dallas IP info sessions
218140	Texas Patents Recruitment Roadshow	Form	New	TX Road Show Survey 2015

ICR Details

OMB Control No: 0651-0080	ICR Reference No: 201506-0651-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOC/PTO	Agency Tracking No:
Title: Clearance for the Collection of Qualitative Feedback
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/07/2015
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/25/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2018	36 Months From Approved
Responses	27,900	0	0
Time Burden (Hours)	5,059	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Improving Agency programs requires ongoing assessment. The Agency will collect, analyze, and interpret information gathered to identify strengths and weaknesses of current services. Based on feedback received, the Agency will identify operational changes needed to improve programs and services. The solicitation of feedback will target areas such as: timeliness, appropriateness, accuracy of information, courtesy, efficiency of service delivery, and resolution of issues with service delivery. The Agency is committed to hearing feedback from its customers. Responses will be assessed to identify service areas in need of improvement. If this information is not collected, then the Agency will miss opportunities to obtain vital feedback from their customers and stakeholders on ways to improve their program and services.

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Authorizing Statute(s): None

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
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 19286	04/10/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 35318	06/19/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 20

table that charts list of burden

IC Title	Form No.	Form Name
G245: LSAC Events	G245 -1	Private Sector Survey
G246: Pro Se Education and Customer Service Feedback	G246	Pro Se Feedback Questions
G248 PatentsView Query Tool Usability Testing	G248	PatentsView Query Tool Questionnaire
G249: Patents Recruitment Open House
G250: Global Patent Prosecution Focus Group
G252 Focus Group Feedback in Support of Next Generation Initiatives	G252-1, G252-2	Audio/Video Consent Form ,   Background Information
G253 Small Discussion Group Feedback in Support of Next Generation Initiatives	G253-1, G253-2	Audio/Video Consent Form ,   Background Information
G254 Usability Testing Feedback in Support of Next Generation Initiatives	G254-1, G254-2, G254-3, G254-4	Audio/Video Consent Form ,   Background Information ,   Participant Scenario Worksheet ,   System Usability Scale
G255 STEPP Pilot Program Surveys	G255-1, G255-2, G255-3	STEPP Evaluation ,   STEPP Needs Assessment Survey ,   STEPP PIlot Interest Form
G257- PTAB E2E System Survey and Focus Group	G257-1	External Engagement Survey
G258-Dallas and San Jose Recruitment Outreach	G258-1	Survey Questions
G259 Post Prosecution Pilot Program (P3)	G259-1	P3 Survey Questions
G260: Electronic Business Center Survey	G260-1	Customer Satisfaction Survey
G261 Patents Pro Bono Metrics Survey	G261-1	Pro Bono Survey Questions
G262 IP Education Outreach Council Events
G263 STEPP Interest Form	G263-1	STEPP Interest Form
G264: 2016 USPTO Trademark Expo Surveys	G264-2, G264-1	Exhibitor Survey ,   Attendee Survey
G265- Global Dossier Survey and Focus Group
G267- HR Employee Relations Survey
Texas Patents Recruitment Roadshow	G220-04, G220-03, G220-01, G220-02	TX Road Show Survey 2015 ,   Dallas IP info sessions ,   Road Show Registration ,   Dallas Open House Regristration

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ICR Summary of Burden

table that charts list 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	27,900	0	0	27,900	0	0
Annual Time Burden (Hours)	5,059	0	0	5,059	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: New generic clearance collection request.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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: 06/25/2015

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