PCT/Model of Power of Attorney

Patent Cooperation Treaty

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0651-0021 can be found here:

Documents and Forms

Document Name Document Type
ed_power.pdf Model of Power of Attorney IC Document

Information Collection (IC) Details

IC Title:	PCT/Model of Power of Attorney	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 1.455

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Economic Development

Subfunction: Intellectual Property Protection

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,829	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	4,829	0	-524	5,353
Annual IC Time Burden (Hours)	1,207	0	-131	1,338
Annual IC Cost Burden (Dollars)	111	-500	-242	853

Documents for IC

Title	Document	Date Uploaded
Model of Power of Attorney	ed_power.pdf	04/23/2013

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