Information Collection

Deposit Account Closure Request Form

IC 187208 under ICR 201409-0651-001 · OMB 0651-0043.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0651-0043 can be found here:

Documents and Forms

Document Name Document Type
Form PTO-2234 Deposit Account Closure Request Form Form
PTO-2234 Deposit Account Closure Request Form DA Closure Request Form.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Deposit Account Closure Request Form	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 2.208 37 CFR 1.25

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	PTO-2234	Deposit Account Closure Request Form	DA Closure Request Form.pdf		No		Paper Only

Line of Business: Economic Development

Subfunction: Intellectual Property Protection

Privacy Act System of Records
Title: Deposit Accounts and Electronic Funds Transfer Profiles	FR Citation: 71 FR 38387

Number of Respondents: 162	Number of Respondents for Small Entity: 41

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	162	-45	207
Annual IC Time Burden (Hours)	3	-11	14
Annual IC Cost Burden (Dollars)	79	-12	91

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.