G325: STEPP Bundle - Individuals or Households

OMB Control No.: 0651-0080

Expiration Date:xx/xx/20xx

Final Interest Request:

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The fields below may be used to request participation in the Stakeholder Training on Examination Practice and Procedure (STEPP) program. Please fill in the information desired below and click on the “submit” button.

Requests to participate in STEPP are granted depending upon resources, training time available, and the intended target audience for each course.

Enter Requesting Information

*Items are mandatory

*Requested Course:__drop down menu___________

*First Name:_________________________________

*Last Name:_________________________________

*Company/Organization:_______________________

*Correspondence Address:

Street Address:_______________________

City:________________________________

State/Province:_______________________

Postal/Zip Code:______________________

Country: ____________________________

*E-mail Address:____________________________

*Telephone Number:_________________________

*Years of Patent Related Experience: (selection: 0-1, 1-3, 3-5, 5+)

*Are you registered to practice law in patent matters before the USPTO? y/n

*Registration number: ___(only fillable if Yes is selected)

*Are you admitted to a state bar in the United States? y/n

*State:___ (only fillable if Yes is selected)

*Bar number:___ (only fillable if Yes is selected)

*Are you an inventor and have you filed, or plan on filing, a patent application? y/n

*Do you plan on filing an application as a Pro Se inventor? y/n

Would you like to be notified of future courses offered by the Office of Patents Stakeholder Experience? y/n

Requests to participate in STEPP are granted depending upon resources, training time available, and the intended target audience for each course.

If you have any feedback, questions or comments regarding STEPP, please email us at [email protected].

Privacy Act Statement

The authority for the collection of this information is 5 U.S.C. § 301, 35 U.S.C. § 2, and E.O. 12862. The information you provide will be used to verify your identity and administer participation in STEPP courses. The information you provide is protected from disclosure to third parties in accordance with the Privacy Act. However, routine uses of this information may include disclosure to the following: Congressional offices; Federal, state, local or foreign agencies; a court, magistrate or administrative tribunal; law enforcement; agents or contractors; the Department of Justice; the National Archives and Records Administration; and agency customers in the course of distributing patent and trademark business information. Disclosure of the information by you is voluntary; however, failure to provide any part of the requested information may result in our inability to enroll you in STEPP courses. The applicable Privacy Act System of Records Notice for this information request is PAT/TM–23, User Access for Web Portals and Information Requests, available at https://www.uspto.gov/uspto-systems-records-notices.

PRA Statement of Burden

A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with an information collection subject to the requirements of the Paperwork Reduction Act of 1995 unless the information collection has a currently valid OMB Control Number. The OMB Control Number for this information collection is 0651-0080. Without this approval, we could not collect this information. Public reporting for this information collection is estimated to be approximately 3 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the Interest Request. All responses to this information collection are voluntary. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden to the Office of the Chief Administrative Officer, United States Patent and Trademark Office, P.O. Box 1450, Alexandria, VA 22313-1450 or email [email protected].