Request to Make Special Under the Law School Clinic Program

Law School Clinic Certification Program

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.