OMB
.report
Search
Tort Claims
Legal Processes
OMB: 0651-0046
IC ID: 180065
OMB.report
DOC/PTO
OMB 0651-0046
ICR 201911-0651-003
IC 180065
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0651-0046 can be found here:
2022-11-22 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
SF95.pdf Claim for Damage, Injury, or Death
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Tort Claims
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 104.41-104.42
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
Economic Development
Subfunction:
Intellectual Property Protection
Privacy Act System of Records
Title:
Patent Examiner Testimony Files
FR Citation:
78 FR 19462
Number of Respondents:
6
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:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
6
0
0
0
0
6
Annual IC Time Burden (Hours)
36
0
0
0
0
36
Annual IC Cost Burden (Dollars)
9
0
4
0
0
5
Documents for IC
Title
Document
Date Uploaded
Claim for Damage, Injury, or Death
SF95.pdf
06/28/2013
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.