Information Collection

iEdison

IC 217416 under ICR 201507-0925-006 · OMB 0925-0002.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0002 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 4 iEdison	Form and Instruction
4 iEdison Burden Statement Attachment 16A iEdison Burden Statement.docx	Form and Instruction
5 iEdison Screen Shot Manage Utilization Report Attachment 16B iEdison Screen Shots_Manage Utilization Reports.pdf	Form and Instruction
6 iEdison screen shot Invention Disclosure Report Attachment 16C iEdison Screen Shots_Invention Disclosure Report.pdf	Form and Instruction
7 iEdison screen shot Patent Record Attachment 16D iEdison Screen Shots_Patent Record.pdf	Form and Instruction
8 iEdison screen shot Registration Request Form Attachment 16F iEdison Screen Shots_Registration Request Form.pdf	Form and Instruction
Attachment 16E iEdison Screen Shots_PVP_Entry_Procedure.pdf Attachment 16E iEdison PVP entry procedure	IC Document

IC Title:

iEdison

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	4	iEdison Burden Statement	Attachment 16A iEdison Burden Statement.docx	Yes	Yes	Fillable Fileable
Form and Instruction	5	iEdison Screen Shot Manage Utilization Report	Attachment 16B iEdison Screen Shots_Manage Utilization Reports.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	6	iEdison screen shot Invention Disclosure Report	Attachment 16C iEdison Screen Shots_Invention Disclosure Report.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	7	iEdison screen shot Patent Record	Attachment 16D iEdison Screen Shots_Patent Record.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	8	iEdison screen shot Registration Request Form	Attachment 16F iEdison Screen Shots_Registration Request Form.pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,697

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5,697	5,697
Annual IC Time Burden (Hours)	1,424	1,424
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment 16E iEdison PVP entry procedure	Attachment 16E iEdison Screen Shots_PVP_Entry_Procedure.pdf	07/09/2015

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