Information Collection

iEdison

IC 217416 under ICR 202210-0925-003 · OMB 0925-0002.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0002 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 4 iEdison	Form and Instruction
4 iEdison Burden Statement Attachment 16A iEdison Burden Statement.docx	Form and Instruction
4 iEdison Burden Statement Attachment 16A iEdison Burden Statement.docx	Form and Instruction
5 iEdison Screen Shot Manage Utilization Report Attachment 16B iEdison Screen Shots_Manage Utilization Reports.pdf	Form and Instruction
5 iEdison Screen Shot Manage Utilization Report Attachment 16B iEdison Screen Shots_Manage Utilization Reports.pdf	Form and Instruction
6 iEdison screen shot Invention Disclosure Report Attachment 16C iEdison Screen Shots_Invention Disclosure Report.pdf	Form and Instruction
6 iEdison screen shot Invention Disclosure Report Attachment 16C iEdison Screen Shots_Invention Disclosure Report.pdf	Form and Instruction
7 iEdison screen shot Patent Record Attachment 16D iEdison Screen Shots_Patent Record.pdf	Form and Instruction
7 iEdison screen shot Patent Record Attachment 16D iEdison Screen Shots_Patent Record.pdf	Form and Instruction
8 iEdison screen shot Registration Request Form Attachment 16F iEdison Screen Shots_Registration Request Form.pdf	Form and Instruction
8 iEdison screen shot Registration Request Form Attachment 16F iEdison Screen Shots_Registration Request Form.pdf	Form and Instruction
Attachment 16E iEdison Screen Shots_PVP_Entry_Procedure.pdf Attachment 16E iEdison PVP entry procedure	IC Document
Attachment 16E iEdison Screen Shots_PVP_Entry_Procedure.pdf Attachment 16E iEdison PVP entry procedure	IC Document

IC Title:

iEdison

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	4	iEdison Burden Statement	Attachment 16A iEdison Burden Statement.docx	Yes	Yes	Fillable Fileable
Form and Instruction	5	iEdison Screen Shot Manage Utilization Report	Attachment 16B iEdison Screen Shots_Manage Utilization Reports.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	6	iEdison screen shot Invention Disclosure Report	Attachment 16C iEdison Screen Shots_Invention Disclosure Report.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	7	iEdison screen shot Patent Record	Attachment 16D iEdison Screen Shots_Patent Record.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	8	iEdison screen shot Registration Request Form	Attachment 16F iEdison Screen Shots_Registration Request Form.pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,697

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-5,697	5,697
Annual IC Time Burden (Hours)	-1,424	1,424
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment 16E iEdison PVP entry procedure	Attachment 16E iEdison Screen Shots_PVP_Entry_Procedure.pdf	07/09/2015

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.