Information Collection

Practitioner's supporting documentation for a motion to hold in abeyance a disciplinary proceeding because of a current disability or addiction

IC 182144 under ICR 201404-0651-004 · OMB 0651-0012.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0651-0012 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Practitioner's supporting documentation for a motion to hold in abeyance a disciplinary proceeding because of a current disability or addiction	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 37 CFR 11.28

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: 1	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1	1
Annual IC Time Burden (Hours)	40	40
Annual IC Cost Burden (Dollars)	11,445	11,445

Documents for IC

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