Regional Program Administrator Survey

Pro Bono Survey

Patent Pro Bono Survey Questions

Regional Program Administrator Survey

OMB: 0651-0082

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Pro Bono Patent Program: QUARTERLY METRIC REPORTING QUESTIONNAIRE - ... Page 2 of 3







OMB No. 0651-00XX


Expires XX/XX/2019



Pro Bono Patent Program

Quarterly Metrics Reporting Questionnaire



Basic Information

[Section 1 of 9]




Name of Person Reporting Metrics*


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First Name Last Name


Email*


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  1. What is the name of your USPTO regional pro bono program?*


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  1. Reporting Year*

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  1. Reporting Period*


First Quarter

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  1. Number of potential applicants who requested services from your program this quarter?*


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  1. What U.S. States does your program serve?*

Shape8 Shape9 Shape10 Shape11 Shape12 Shape13 Shape14 Shape15 Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware

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Florida

Shape20 Shape21 Shape22 Shape23 Shape24 Shape25 Shape26 Shape27 Shape28 Shape29 Shape30 Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland

Shape31 Shape32 Shape33 Shape34 Shape35 Shape36 Shape37 Shape38 Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada

Shape39 Shape40 Shape41 Shape42 New Hampshire New Jersey New Mexico New York

Shape43 Shape44 Shape45 Shape46 Shape47 Shape48 Shape49 Shape50 Shape51 Shape52 Shape53 Shape54 North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas

Shape55 Shape56 Shape57 Shape58 Utah Vermont Virginia Washington

Shape59 Shape60 Shape61 Shape62 Washington, D.C. West Virginia Wisconsin Wyoming

[Check all that apply]




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Progress

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Referral Sources

[Section 2 of 9]




  1. Number of applicants applying from each U.S. State?


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[e.g. CA = 35; NV = 6; HI = 2; AK = 1; etc.]


  1. Number of applicants referred to your program by the Federal Circuit Bar?*


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  1. Number of applicants that came directly to your regional program?*


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  1. Number of applicants that came from another source?


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  1. If applicable, list other sources of referrals:


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[e.g. from a law firm; law school; small business development center; etc.]


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Progress

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11. Number of applicants completing and returning the financial screening application this quarter?


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[Where regional program uses a financial screening application form]



  1. Number of financial screenings approved this quarter?


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Progress

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Invention Screening

[Section 4 of 9]




13. Number of invention screenings approved this quarter?


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14. Total number of applications approved for placement with an attorney/agent this quarter?


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Disqualifications

[Section 5 of 9]




15. Total number of applicants disqualified (for any reason)?


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  1. List reasons for disqualifications below:


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Progress

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Placement Information

[Section 6 of 9]




17. Number of applicants placed with an attorney/agent this quarter*


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[Providers include: law firms; in-house legal teams; solo attorneys; etc.]



18. Breakdown placements by state


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[Use the applicant’s state as the state of placement, e.g., AL – 4; MS = 2.]


19. Number of applicants placed -- but cancelled this quarter?

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  1. Cumulative backlog


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[Total number of applicants approved for placement but not matched with an attorney/agent for legal services as of the end of this quarter]




Panel Attorney Information

[Section 7 of 9]



Shape86 21. Total number of corporations and law firms agreeing to accept cases as of the last day of this quarter?




22. Total number of attorneys agreeing to accept cases as of the last day of this quarter?


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[Total number of applicants approved for placement but not matched with an attorney/agent for legal services as of the end of this quarter]


Shape88 23. Estimated number of hours donated by lawyer referral service panel attorneys serving in your program during this quarter?*





Patent Categories

[Section 8 of 9]



24. Number of provisional patent applications filed through the Program this quarter?


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25. Number of non-provisional patent applications filed through the Program this quarter?


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26. Number of design patent applications filed through the Program this quarter?


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27. List the patent numbers for the patents that issued this quarter?


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[Patent numbers are formatted X,XXX,XXX; do not list patent application numbers, which are formatted XX/XXX,XXX]



Program Financial Information

[Section 9 of 9]

To be completed twice a year for the period beginning January 1st, ending June 30th, and the period beginning July 1st, ending December 31st only if your program has an active Memorandum of Agreement with the USPTO.



28. Based on your current finances, as of today, what is the percentage of the total project cost (as listed in your current JPA) that your organization is able to cover?


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29. What is the total number of donors who have made multi-year (calendar year) commitments or the number of donors who have donated for more than one year in the previous three years?

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30. What is the total number of donors who have donated for the first time this calendar year?


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31. What is the total number of donors who have donated to your program this calendar year?


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Progress

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Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB Control Number. The data collected from this survey will be used for planning efforts to ensure that visits to the public search facility are productive and positive experiences. The responses will be aggregated. This collection of information is voluntary in accordance with E.O. 12862, "Setting Customer Service Standards." All repossess will remain confidential and are protected under the "Confidential Information Protection and Statistical Efficiency Act of 2002." This survey contains 31 questions and the USPTO estimates that it will take approximately 2 hours to complete this survey.



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Progress

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7/27/2016

https://cla.formstack.com/forms/patent_probono_q_reports


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