Patent Applicant Intake Form

Patent and PTAB Pro Bono Programs

Documents and Forms

Document Name Document Type
Form USPTO/551 Patent Applicant Intake Form Form
USPTO/551 Patent Applicant Intake Form 0651-0082 USPTO551 Patent Applicant Intake Form.docx Form
USPTO/551 Patent Applicant Intake Form 0651-0082 USPTO551 Patent Applicant Intake Form.docx Form

Information Collection (IC) Details

IC Title:	Patent Applicant Intake Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	USPTO/551	Patent Applicant Intake Form	0651-0082 USPTO551 Patent Applicant Intake Form.docx		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Intellectual Property Protection

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,700	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,700	674	1,026
Annual IC Time Burden (Hours)	136	119	17
Annual IC Cost Burden (Dollars)	0	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.