Information Collection

Surcharge after expiration - Late payment is unavoidable

IC 219776 under ICR 201601-0651-021 · OMB 0651-0016.

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Information Collection (IC) Details

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IC Title:	Surcharge after expiration - Late payment is unavoidable	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 37 CFR 1.20(i)(1)

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: 12	Number of Respondents for Small Entity: 1

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

Percentage of Respondents Reporting Electronically: 97 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	12	12
Annual IC Time Burden (Hours)	96	96
Annual IC Cost Burden (Dollars)	8,050	8,050

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