Information Collection

Petition to Cancel

IC 37421 under ICR 201705-0651-001 · OMB 0651-0040.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0651-0040 can be found here:

Documents and Forms

Document Name Document Type
cancellationformat.pdf Other-Suggested Format

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Petition to Cancel	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 2.111 and 2.112

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Suggested Format			cancellationformat.pdf		No		Paper Only

Line of Business: Economic Development

Subfunction: Intellectual Property Protection

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5	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: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	5	-19	24
Annual IC Time Burden (Hours)	3	-9	12
Annual IC Cost Burden (Dollars)	2,643	-9,423	12,066

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.