Information Collection

Application by Law School Faculty Member to Become a Faculty Clinic Supervisor

IC 218683 under ICR 202501-0651-002 · OMB 0651-0081.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0651-0081 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Application for Law School Faculty Member to Become a Faculty Clinic Supervisor Application by Law School Faculty Member to Become a Faculty Clinic Supervisor	Form and Instruction
Application for Law School Faculty Member to Become a Fa Application for Law School Faculty Member to Become a Faculty Clinic Supervisor.pdf	Form and Instruction

IC Title:

Application by Law School Faculty Member to Become a Faculty Clinic Supervisor

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 11.16-17

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	N/A				Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Intellectual Property Protection

Privacy Act System of Records

Title: PAT-TM-1 Attorneys and Agents Registered or Recognized to Practice Before the Office

FR Citation: 78 FR 16839

Number of Respondents: 10

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 99 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

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.

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