G406 GIPA Domestic Survey 2024

Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

G406 GIPA Domestic Survey 2024

OMB: 0651-0080

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OMB Control No.: 0651-0080
Expiration Date: XX/XX/XXXX

Outreach	Short	Survey	-	OMB	Approval	-	Net
Promoter	Score	Question	#2

1. Pleaser	enter	the	date	attended.

Event	Date
Date

MM/DD/YYYY

2. How	likely	is	it	that	you	would	recommend	the	(workshop,	seminar,	conference,
program,	or	event)	to	a	friend	or	colleague?
Not	at	all	likely
0

1

Extremely	likely
2

3

4

5

6

7

8

9

10

3. Overall,	how	satisfied	or	dissatisfied	are	you	with	the	(workshop,	seminar,
conference,	program,	or	event)?
Very	satisfied

Dissatisfied

Satisfied

Very	dissatisfied

Neither	satisfied	nor	dissatisfied

4. This	(workshop,	seminar,	conference,	program,	or	event)	enhanced	my
understanding	of	the	topic?
Strongly	agree

Disagree

Agree

Strongly	disagree

Neither	agree	nor	disagree

5. This	(workshop,	seminar,	conference,	program,	or	event)	enhanced	my
understanding	of	the	topic.
Strongly	agree
Agree
Neither	agree	nor	disagree
Disagree
Strongly	disagree

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 valid OMB Control
Number. The OMB Control Number for this information collection is 0651-0080. Public burden for this survey is estimated to average 5 mintues per
response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the information collection. 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].

6. Based	on	the	information	presented	to	you,	how	likely	would	you	be	to	use	the
information	from	the	(workshop,	seminar,	conference,	program,	or	event)?
Very	likely
Likely
Neither	likely	nor	unlikely
Unlikely
Very	unlikely

7. How	did	you	hear	about	the	(workshop,	seminar,	conference,	program,	or	event)?
Check	all	that	apply.
USPTO.gov	website

Email	announcement

Social	media	(e.g.,	Facebook,	Twitter)

Colleague	/	Friend

Host	other	than	USPTO

Attendance	at	a	previous	event

Other	(please	specify)

8. Please	share	any	other	comments	you	have	below:

Thank	you	for	taking	this	survey.

This	program	is	presented	by	the	USPTO’s	Global	Intellectual	Property	Academy,	a	unit	of	the	Office	of	Policy	
and	International	Affairs	(OPIA).	OPIA	assists	the	Under	Secretary	of	Commerce	for	Intellectual	Property	and	
Director	of	the	USPTO	in	advising	the	President	(through	the	Secretary	of	Commerce)	and	federal	agencies	
on	domestic	and	international	IP	issues	as	well	as	on	U.S.	treaty	obligations.	It	also	provides	technical	
assistance	and	training	on	IP-related	matters	to	U.S.	stakeholders	and	both	U.S.	and	foreign	government	
officials.
Survey	Instructions
Approved	for	use	through	XX/XX/XXXX.	OMB	0651-0080
U.S.	Patent	and	Trademark	Office;	U.S.	DEPARTMENT	OF	COMMERCE
Under	the	Paperwork	Reduction	Act	of	1995,	no	persons	are	required	to	respond	to	a	collection	of	
information	unless	it	contains	a	valid	OMB	control	number.
PRA	Act	Statement:
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.	Public	burden	for	this	form	is	
estimated	to	average	15	minutes	per	response,	including	the	time	for	reviewing	instructions,	searching	
existing	data	sources,	gathering	and	maintaining	the	data	needed,	and	completing	and	reviewing	the	
information	collection.	Response	to	this	information	collection	is	voluntary;	however,	it	allows	the	USPTO	to	
analyze	the	overall	effectiveness	of	the	program.	Send	comments	regarding	this	burden	estimate	or	any	
other	aspect	of	this	information	collection,	including	suggestions	for	reducing	this	burden	to	the	Chief	
Administrative	Officer,	United	States	Patent	and	Trademark	Office,	P.O.	Box	1450,	Alexandria,	VA	223131450	or	email	[email protected].


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