Information Collection

G417: Pre-Application Assessment Program Registration and Survey

IC 270959 under ICR 202408-0651-003 · OMB 0651-0080.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
G417: Pre-Application Assessment Program Registration and Survey	Form
G417 Pre-Application Assessment Program Survey Questions.docx	Other-Survey
G417 Pre-Application Assessment Program Survey Questions.docx	Other-Survey
Pre-Application Assessment Program Interest Form G417 Pre_Application Assessment Program Interest Form.docx	Form
Pre-Application Assessment Program Interest Form G417 Pre_Application Assessment Program Interest Form.docx	Form
G417 Pre-Application Assessment Program Registration & Survey Submission Request 2024.docx G417 Pre-Application Assessment Program Registration &Survey Submission Request	IC Document
G417 Pre-Application Assessment Program Registration & Survey Submission Request 2024.docx G417 Pre-Application Assessment Program Registration &Survey Submission Request	IC Document

IC Title:

Agency IC Tracking Number:

G417

IC Status: New

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	Pre-Application Assessment Program Interest Form	G417 Pre_Application Assessment Program Interest Form.docx		Yes	Yes	Fillable Fileable
Other-Survey			G417 Pre-Application Assessment Program Survey Questions.docx		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Intellectual Property Protection

Privacy Act System of Records

Title: PAT-TM-19: Dissemination Events and Registrations

FR Citation: 71 FR 77739

Number of Respondents: 660

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	660	660
Annual IC Time Burden (Hours)	58	58
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
G417 Pre-Application Assessment Program Registration &Survey Submission Request	G417 Pre-Application Assessment Program Registration & Survey Submission Request 2024.docx	09/13/2024

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