National Medal of Technology and Innovation Nomination Application

ICR 201502-0651-003 · OMB 0651-0060 · Historical Active

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0651-0060 can be found here:

Forms and Documents

Document	Type	Status	Availability
National Medal of Technology and Innovation Nomination Form	Form and Instruction	Modified	Repair queued
0060 Supporting Statement.docx	Supporting Statement A	Uploaded 2015-02-25	Repair queued
NMTI Nomination Form 2013.doc	Supplementary Document	Uploaded 2013-02-01	Repair queued
Nomination_Guidelines_page.pdf	Supplementary Document	Uploaded 2012-02-23	Available
NMTI Letter_of_Recommendation.pdf	Supplementary Document	Uploaded 2012-02-23	Available
NMTI NominationForm_2012.pdf	Supplementary Document	Uploaded 2012-02-23	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
187443	National Medal of Technology and Innovation Nomination Form	Form and Instruction	Modified

ICR Details

OMB Control No: 0651-0060	ICR Reference No: 201502-0651-003
Status: Historical Active	Previous ICR Reference No: 201301-0651-004
Agency/Subagency: DOC/PTO	Agency Tracking No:
Title: National Medal of Technology and Innovation Nomination Application
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/10/2015
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/02/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2018	36 Months From Approved	04/30/2015
Responses	50	0	40
Time Burden (Hours)	2,000	0	1,600
Cost Burden (Dollars)	2	0	0

Abstract: The public uses the National Medal of Technology and Innovation Nomination Application to recognize through nomination an individual's or company's extraordinary leadership and innovation in technological achievement. The application must be accompanied by at least six letters of recommendation or support from individuals who have first-hand knowledge of the cited achievement(s). The National Medal of Technology and Innovation Laureates are announced by the White House and the Department of Commerce once the Medallists are notified of their selection.

Authorizing Statute(s): US Code: 15 USC 3711 Name of Law: null

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 71399	12/02/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 9442	02/23/2015
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
National Medal of Technology and Innovation Nomination Form	N/A	National Medal of Technology and Innovation 2013 Nomination Form

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	50	40	10
Annual Time Burden (Hours)	2,000	1,600	400
Annual Cost Burden (Dollars)	2	0	2

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

Annual Cost to Federal Government:

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Richard Maulsby 571 272-8333

Common Form ICR: No