Information Collection

Section 12(c) Affidavit (Private Sector)

IC 216719 under ICR 202109-0651-003 · OMB 0651-0055.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0651-0055 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form PTO-2311 Section 12(c) Affidavit (Private Sector)	Form and Instruction
PTO-2311 Section 12(c) Affidavit 0651-0055 PTO-2311 Section 12(c) Affidavit.docx teas.uspto.gov/gf/spring/nonteas?execution=e5s1	Form and Instruction
PTO-2311 Section 12(c) Affidavit 0651-0055 PTO-2311 Section 12(c) Affidavit.docx teas.uspto.gov/gf/spring/nonteas?execution=e5s1	Form and Instruction

IC Title:

Section 12(c) Affidavit (Private Sector)

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 2.160

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 and Instruction	PTO-2311	Section 12(c) Affidavit	0651-0055 PTO-2311 Section 12(c) Affidavit.docx	https://teas.uspto.gov/gf/spring/nonteas?execution=e5s1	Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Intellectual Property Protection

Privacy Act System of Records

Title: COMMERCE/USPTO-26 Trademark Application and Regristation Records

FR Citation: 85 FR 8847

Number of Respondents: 1

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 99 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1	0	1
Annual IC Time Burden (Hours)	1	1	0
Annual IC Cost Burden (Dollars)	100	0	100

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.