G253-2 Background Information

Clearance for the Collection of Qualitative Feedback

Form - Background Information Apr 16

G253 Small Discussion Group Feedback in Support of Next Generation Initiatives

OMB: 0651-0080

Document [docx]
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OMB Control Number 0651-0080

Expiration Date: 08/31/18


Background Information



The United States Patent and Trademark Office (USPTO) is in the process of redesigning our current web based sites and applications, and developing new capabilities for the future. You can gain experience with these new systems prior to their public release and help the USPTO refine their functionality by volunteering to provide feedback.


We are currently asking for volunteers to help with [insert current aspect of project here]


If you are interested, please fill out the following form and we will follow up with you shortly.


  1. Name:_____________________


  1. Email:_____________________


  1. Phone:_____________________


  1. Occupation: ______________________


  1. Role at work: _____________________


  1. I am able to (please select all possibilities): [include only relevant options of current request]


 Visit the USPTO headquarters in person (Alexandria, Virginia)


 Provide feedback via video conference (high speed internet access required)


 Fill out a survey online (internet access required)


 Host a meeting at my workplace where multiple employees are available to provide feedback


  1. What USPTO systems do you currently use? (e.g. Electronic Business Center, EFS Web)


System name(s): ________________________________________________________________


______________________________________________________________________________


  1. What other systems do you routinely access during your job (non-USPTO)?


System name(s): ________________________________________________________________


______________________________________________________________________________


  1. Which USPTO business units do you deal with on a regular basis?


Business unit name(s): ___________________________________________________________


______________________________________________________________________________



  1. In general, based on your experience, what do you like about the USPTO systems?


______________________________________________________________________________


  1. In general, based on your experience, what do you not like about the USPTO systems?


______________________________________________________________________________


  1. Which of the following categories includes your birth year (optional)?


Before 1946

1946-1964

1965-1978

1979-1990

After 1990


  1. What is the highest level of education you’ve completed (optional)? ____________________
































This information collection contains requirements subject to the Paperwork Reduction Act (PRA). Notwithstanding any other provisions of the law, no person is required to respond to, nor shall any person be subject to penalty for failure to comply with, a collection of information subject to the requirements of the PRA, unless that collection of information displays a currently valid OMB Control Number. The estimated response time for this collection is two hours. The response time includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorUSPTO
File Modified0000-00-00
File Created2021-01-24

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