Information Collection

Request to Make Special Under the Law School Clinic Program

IC 218686 under ICR 201510-0651-001 · OMB 0651-0081.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0651-0081 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form PTO/SB/419 Request to Make Special Under the Law School Clinic Program	Form
PTO/SB/419 Certification and Request to Make Special Under the Law Law_School_Pilot_Request_to_Make_Special_Form_-_FINAL2.docx	Form

IC Title:

Request to Make Special Under the Law School Clinic Program

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 37 CFR 11.16-17

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
Form	PTO/SB/419	Certification and Request to Make Special Under the Law School Program	Law_School_Pilot_Request_to_Make_Special_Form_-_FINAL2.docx		No		Fillable Printable

Line of Business: Economic Development

Subfunction: Intellectual Property Protection

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 75 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	30	0	30
Annual IC Time Burden (Hours)	30	0	30
Annual IC Cost Burden (Dollars)	40	40	0

Documents for IC

table that charts IC Documents
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.