Information Collection

Application by Law School Faculty Member to Become a Faculty Clinic Member

IC 218683 under ICR 201510-0651-001 · OMB 0651-0081.

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Information Collection (IC) Details

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IC Title:	Application by Law School Faculty Member to Become a Faculty Clinic Member	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 37 CFR 11.16-17

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: 30	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 75 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	30	0	30
Annual IC Time Burden (Hours)	30	0	30
Annual IC Cost Burden (Dollars)	40	40	0

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