Information Collection

National Medal of Technology and Innovation Nomination Form

IC 187443 under ICR 202103-0651-002 · OMB 0651-0060.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0651-0060 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
National Medal of Technology and Innovation Nomination Form	Form
National Medal of Technology and Innovation Nomination F PTO-NMTI-1.docx www.uspto.gov/sites/default/files/documents/NMTI-Nomination-Form-2021.pdf	Form
National Medal of Technology and Innovation Nomination F PTO-NMTI-1.docx www.uspto.gov/sites/default/files/documents/NMTI-Nomination-Form-2021.pdf	Form

IC Title:

National Medal of Technology and Innovation Nomination Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	N/A	National Medal of Technology and Innovation Nomination Form	PTO-NMTI-1.docx	https://www.uspto.gov/sites/default/files/documents/NMTI-Nomination-Form-2021.pdf	Yes	Yes	Fillable Fileable Signable

Line of Business: Economic Development

Subfunction: Intellectual Property Protection

Privacy Act System of Records

Title: COMMERCE/PAT-TM-21 National Medal of Technology and Innovation Nominations

FR Citation: 73 FR 4850

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	2,000	2,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.