G276 Silicon Valley Events Survey Submission Request

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0651-0080)

TITLE OF INFORMATION COLLECTION: G276: Silicon Valley USPTO Events Survey

PURPOSE: To evaluate effectiveness of events for content improvement, promotion planning, and scheduling for future events. Roughly 4-5 events will be conducted per month over the next year.

DESCRIPTION OF RESPONDENTS:

Silicon Valley USPTO event attendees (pro se inventors, small businesses, entrepreneurs, legal community, university and K-12 community).

TYPE OF COLLECTION: (Check one or multiple)

[ ] Customer Comment Card/Complaint Form [ x ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [ ] Other: _________________

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Business Unit: _________/OUS/_ or /U/DIR/_______________________

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [ x ] No

1a. If Yes, is the information that will be collected included in records that are subject to

the Privacy Act of 1974? [ ] Yes [ ] No

2. If applicable, has a System of Records Notice been published? [ ] Yes [ x ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [ x ] No

BURDEN HOURS

Name of Instrument	No. of Respondents	Participation Time	Burden
Silicon Valley USPTO Event Survey via Survey Monkey	1,200	5 min	100 hours
Totals	1,200		100 hours

The USPTO estimates that 100% of the surveys (small discussions, focus groups, etc.) will be conducted electronically.

FEDERAL COST: The estimated annual cost to the Federal government is the combined average hourly rate of $51.48 per hour for a GS-13 step 5 + 15.44 (30%) * 30 hours, which totals an hourly rate of $66.92. $66.92 * 30 hours = $2,007.60

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [ x ] Yes [ ] No

This survey will be given to public stakeholders attending events/workshops at the Silicon Valley USPTO.

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

All attendees will be provided a link to the survey before they leave the event.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ x ] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain: live poll software

2. Will interviewers or facilitators be used? [ ] Yes [ x ] No

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