National Medal of Technology and Innovation Nomination Application

Forms and Documents

Document Name	Status
National Medal of Technology and Innovation Nomination Form Form and Instruction	New
0651-00xx NMTI Supporting Statement 4Dec08.doc Supporting Statement A	2008-12-10

IC Document Collections

IC ID	Document Title	Status
187443	National Medal of Technology and Innovation Nomination Form Form and Instruction	New

ICR Details

OMB Control No: 0651-0060	ICR Reference No: 200812-0651-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOC/PTO	Agency Tracking No:
Title: National Medal of Technology and Innovation Nomination Application
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 01/05/2009
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/15/2009
	Date Received in OIRA: 12/16/2008
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2009	01/31/2009
Responses	40	0	0
Time Burden (Hours)	1,600	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The public uses the National Medal of Technology and Innovation Nomination Application to recognize through nomination an individual's or company's extraordinary leadership and innovation in technological achievement. The application must be accompanied by at least six letters of recommendation or support from individuals who have first-hand knowledge of the cited achievement(s). The National Medal of Technology and Innovation Laureats are announced by the White House and the Department of Commerce once the Medalists are notified of their selection.

Emergency Justfication: In lieu of a transfer of the Technology Administration collection 0692-0001, National Medal of Technology, the USPTO is requesting the creation of a new collection under 0651 which would effectively transfer as well as update the collection. An expedited review and approval of this ICR would allow the USPTO to request nominations in January 2009 and allow for timely nomination reviews and effective support for the subsequent Presidential Award Ceremony.

---

Authorizing Statute(s): US Code: 15 USC 3711 Name of Law: null
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 57337	10/02/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 76003	12/15/2008
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
National Medal of Technology and Innovation Nomination Form	N/A	National Medal of Technology and Innovation 2009 Nomination Form

---

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	40	0	0	40	0	0
Annual Time Burden (Hours)	1,600	0	0	1,600	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The USPTO is requesting the approval of the creation of a new collection for 0651 and an updated version of the formerly approved nomination application form used in the past by the Technology Administration.

---

Annual Cost to Federal Government: $12,403

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/16/2008

---