National Medal of Technology and Innovation Nomination Form

National Medal of Technology and Innovation Nomination Application

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0651-0060 can be found here:

Documents and Forms

Document Name Document Type
National Medal of Technology and Innovation Nomination Form Form and Instruction
National Medal of Technology and Innovation 2009 Nominat NominationForm_2009.doc Form and Instruction

Information Collection (IC) Details

IC Title:	National Medal of Technology and Innovation Nomination Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	National Medal of Technology and Innovation 2009 Nomination Form	NominationForm_2009.doc		Yes	No	Fillable Printable

Line of Business: Economic Development

Subfunction: Intellectual Property Protection

Privacy Act System of Records
Title: COMMERCE/PAT-TM-21 National Medal of Technology and Innovation Nominations	FR Citation: 73 FR 4850

Number of Respondents: 40	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	1,600	1,600
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.