Certification and 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⚠️ Notice: This information collection may be referencing outdated material.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 Certification and Request to Make Special Under the Law School Clinic Program Form
0033 EFS web user page.mht.pdf efs.uspto.gov/EFSWebUIUnregistered/EFSWebUnregistered Other-Website
PTO/SB/419 CERTIFICATION AND REQUEST TO MAKE SPECIAL UNDER THE LAW Law_School_Request_to_Make_Special_Form_FINAL.docx www.uspto.gov/learning-and-resources/ip-policy/public-information-about-practitioners/law-school-clinic-1 Form

Information Collection (IC) Details

IC Title:	Certification and Request to Make Special Under the Law School Clinic Program	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 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_Request_to_Make_Special_Form_FINAL.docx	https://www.uspto.gov/learning-and-resources/ip-policy/public-information-about-practitioners/law-school-clinic-1	Yes	Yes	Fillable Fileable Signable
Other-Website			0033 EFS web user page.mht.pdf	https://efs.uspto.gov/EFSWebUIUnregistered/EFSWebUnregistered	Yes	Yes	Fillable Fileable Signable

Line of Business: Economic Development

Subfunction: Intellectual Property Protection

Privacy Act System of Records
Title: Patent Application Files	FR Citation: 78 FR 19243

Number of Respondents: 2	Number of Respondents for Small Entity: 2

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 75 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2	-28	30
Annual IC Time Burden (Hours)	2	-28	30
Annual IC Cost Burden (Dollars)	7	-33	40

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.