Petition for Derivation

Patent Review and Derivation Proceedings

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0651-0069 can be found here:

Documents and Forms

Document Name Document Type

no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

IC Title:	Petition for Derivation	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 37 CFR 42.63 37 CFR 42.11 37 CFR 42.65 37 CFR 42.402 through 42.406 37 CFR 42.8 37 CFR 42.13 37 CFR 42.5 and 42.6 37 CFR 42.20 through 42.22 37 CFR 42.24(a)(4)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Economic Development

Subfunction: Intellectual Property Protection

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11	Number of Respondents for Small Entity: 1

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	11	0	11
Annual IC Time Burden (Hours)	1,818	0	1,818
Annual IC Cost Burden (Dollars)	4,620	220	4,400

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.