Submission Request Form

Request for Approval under the “Generic Clearance for the Collection of
Routine Customer Feedback” (OMB Control Number: 0690-0030)
TITLE OF INFORMATION COLLECTION:
Intellectual Property (IP) Awareness Assessment Tool Feedback
PURPOSE:
The Inventor Assistance Program at the United States Patent and Trademark Office (USPTO)
wishes to increase intellectual property awareness among the independent inventors, minorityowned business owners, and owners of other small and medium-sized enterprises. To this end,
the USPTO is developing an online web-based tool (Intellectual Property (IP) Awareness
Assessment Tool) to assess the independent inventors/owners intellectual property awareness.
A prototype of the assessment tool is currently under development. The USPTO envisions that
the prototype will contain ten categories covering various aspects of intellectual property and
that each category will contain four to ten questions.
The IP Awareness Assessment Tool consists of two sections: the assessment tool and a customer
satisfaction survey. The USPTO plans to test the assessment tool using volunteers from industry
meetings, tradeshows, and industry sub-group meetings. Once the volunteers complete the tool,
the USPTO will survey them regarding their experience using the tool and their feedback
regarding any improvements.
Based on responses to the assessment tool prototype, the USPTO will create customized and
targeted training packages for the independent inventors/owners. The USPTO will use the
feedback from the customer satisfaction survey to develop and improve the full version of the
tool.
DESCRIPTION OF RESPONDENTS:
The respondents are independent inventors, owners of small or medium-sized businesses, and
minority-owned businesses. They have varying degrees of intellectual property awareness. The
USPTO plans to provide the assessment tool to 50-60 inventors/businesses at conferences such
as the Manufacture Extension Partnership Conference, the Independent Inventor Conference, and
the Small Business Development Authority meetings.
TYPE OF COLLECTION: (Check one)
[ ] Customer Comment Card/Complaint Form
[ ] Usability Testing (e.g., Website or Software)
[] Focus Group

[x] Customer Satisfaction Survey
[ ] Small Discussion Group
[ ] Other: ___________

CERTIFICATION:
I certify the following to be true:
1. The collection is voluntary.
2. The collection is low-burden for respondents and low-cost for the Federal Government.

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3. The collection is non-controversial and does not raise issues of concern to other federal
agencies.
4. The results are not intended to be disseminated to the public.
5. Information gathered will not be used for the purpose of substantially informing influential
policy decisions.
6. The collection is targeted to the solicitation of opinions from respondents who have
experience with the program or may have experience with the program in the future.
Name: Holly Higgins
To assist review, please provide answers to the following questions:
Personally Identifiable Information:
1. Is personally identifiable information (PII) collected? [ ] Yes [x] No
2. If Yes, is the information that will be collected included in records that are subject to the
Privacy Act of 1974? [ ] Yes [ ] No
3. If Applicable, has a System or Records Notice been published? [ ] Yes [ ] No
Gifts or Payments:
Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to
participants? [ ] Yes [ x] No
BURDEN HOURS
Category of Respondent
Individuals or Households
Totals

No. of
Respondents
60

Participation Burden
Time
1 hr
60 hr

60

60 hr

FEDERAL COST: The estimated annual cost to the Federal government is $560.

If you are conducting a focus group, survey, or plan to employ statistical methods, please
provide answers to the following questions:

The selection of your targeted respondents
1. Do you have a customer list or something similar that defines the universe of potential
respondents and do you have a sampling plan for selecting from this universe?
[ ] Yes [x] No
If the answer is yes, please provide a description of both below (or attach the sampling plan)? If
the answer is no, please provide a description of how you plan to identify your potential group of
respondents and how you will select them?
The USPTO will request volunteers at the various industry meetings, tradeshows, and industry
sub-group meetings to complete the IP Awareness Assessment Tool. The chosen venues where
the survey will be conducted are targeted for the potential group of respondents.

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Administration of the Instrument
1. How will you collect the information? (Check all that apply)
[x] Web-based or other forms of Social Media
[ ] Telephone
[x] In-person
[ ] Mail
[ ] Other, Explain
2. Will interviewers or facilitators be used? [ ] Yes [x] No
Please make sure that all instruments, instructions, and scripts are submitted with the
request.

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