Form PTO/SB/66 Petition to Accept Unintentionally Delayed Payment of Ma

A31 PTO/SB/66
Approved for use through 04/30/2009. OMB 0651-0016
U.S. Patent and Trademark Office: U.S. DEPARTMENT OF COMMERCE
Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays valid OMB control number.

PETITION TO ACCEPT UNINTENTIONALLY DELAYED PAYMENT OF MAINTENANCE FEE IN AN
EXPIRED PATENT (37 CFR 1.378(c))
Patent Number

Issue Date
(YYYY-MM-DD)

Application
Number

Filing Date
(YYYY-MM-DD)

Docket Number (if applicable)

CAUTION: Maintenance fee (and surcharge, if any) payment must correctly identify: (1) the patent number and (2) the application number
of the actual U.S. application leading to issuance of that patent to ensure the fee(s) is/are associated with the correct patent. 37 CFR
1.366(c) and (d).
SMALL ENTITY
Patentee claims, or has previously claimed, small entity status. See 37 CFR 1.27.
LOSS OF ENTITLEMENT TO SMALL ENTITY STATUS
Patentee is no longer entitled to small entity status. See 37 CFR 1.27(g)
Small Entity

NOT Small Entity
Fee
3 ½ year

Code
(1551)

Fee
3 ½ year

Code
(2551)

7 ½ year

(1552)

7 ½ year

(2552)

11 ½ year

(1553)

11 ½ year

(2553)

SURCHARGE
The surcharge required by 37 CFR 1.20(i)(2) (Fee Code 1558) must be paid as a condition of accepting unintentionally delayed payment
of the maintenance fee.
MAINTENANCE FEE (37 CFR 1.20(e)-(g))
The appropriate maintenance fee must be submitted with this petition.
STATEMENT
THE UNDERSIGNED CERTIFIES THAT THE DELAY IN PAYMENT OF THE MAINTENANCE FEE TO THIS PATENT WAS
UNINTENTIONAL
PETITIONER(S) REQUEST THAT THE DELAYED PAYMENT OF THE MAINTENANCE FEE BE ACCEPTED AND THE PATENT
REINSTATED
THIS PORTION MUST BE COMPLETED BY THE SIGNATORY OR SIGNATORIES
37 CFR 1.378(d) states: “Any petition under this section must be signed by an attorney or agent registered to practice before the Patent
and Trademark Office, or by the patentee, the assignee, or other party in interest.”
I certify, in accordance with 37 CFR 1.4(d)(4) that I am
An attorney or agent registered to practice before the Patent and Trademark Office
A sole patentee
A joint patentee; I certify that I am authorized to sign this submission on behalf of all the other patentees.
A joint patentee; all of whom are signing this e-petition
The assignee of record of the entire interest

EFS - Web 2.1

A31 PTO/SB/66
Approved for use through 04/30/2009. OMB 0651-0016
U.S. Patent and Trademark Office: U.S. DEPARTMENT OF COMMERCE
Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays valid OMB control number.

Patent Practitioner
A signature of the applicant or representative is required in accordance with 37 CFR 1.33 and 10.18. Please see 37 CFR 1.4(d) for the
form of the signature

Signature

Date (YYYY-MM-DD)

Name

Registration Number

This collection of information is required by 37 CFR 1.378(c). The information is required to obtain or retain a benefit by the public which
is to file (and by the USPTO to process) an application. Confidentiality is governed by 35 U.S.C. 122 and 37 CFR 1.11 and 1.14. This
collection is estimated to take 1 hour to complete, including gathering, preparing, and submitting the completed application form to the
USPTO. Time will vary depending upon the individual case. Any comments on the amount of time you require to complete this form and/
or suggestions for reducing this burden, should be sent to the Chief Information Officer, U.S. Patent and Trademark Office, U.S.
Department of Commerce, P.O. Box 1450, Alexandria, VA 22313-1450. DO NOT SEND FEES OR COMPLETED FORMS TO THIS
ADDRESS. This form can only be used when in conjunction with EFS-Web. If this form is mailed to the USPTO, it may cause
delays in reinstating the patent.

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Privacy Act Statement

The Privacy Act of 1974 (P.L. 93-579) requires that you be given certain information in connection with your submission of
the attached form related to a patent application or patent. Accordingly, pursuant to the requirements of the Act, please be
advised that: (1) the general authority for the collection of this information is 35 U.S.C. 2(b)(2); (2) furnishing of the
information solicited is voluntary; and (3) the principal purpose for which the information is used by the U.S. Patent and
Trademark Office is to process and/or examine your submission related to a patent application or patent. If you do not
furnish the requested information, the U.S. Patent and Trademark Office may not be able to process and/or examine your
submission, which may result in termination of proceedings or abandonment of the application or expiration of the patent.
The information provided by you in this form will be subject to the following routine uses:
1.

The information on this form will be treated confidentially to the extent allowed under the Freedom of Information
Act (5 U.S.C. 552) and the Privacy Act (5 U.S.C. 552a). Records from this system of records may be disclosed to the
Department of Justice to determine whether the Freedom of Information Act requires disclosure of these record s.

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A record from this system of records may be disclosed, as a routine use, in the course of presenting evidence to
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negotiations.

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request involving an individual, to whom the record pertains, when the individual has requested assistance from the
Member with respect to the subject matter of the record.

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A record in this system of records may be disclosed, as a routine use, to a contractor of the Agency having need
for the information in order to perform a contract. Recipients of information shall be required to comply with the
requirements of the Privacy Act of 1974, as amended, pursuant to 5 U.S.C. 552a(m).

5.

A record related to an International Application filed under the Patent Cooperation Treaty in this system of
records may be disclosed, as a routine use, to the International Bureau of the World Intellectual Property
Organization, pursuant to the Patent Cooperation Treaty.

6.

A record in this system of records may be disclosed, as a routine use, to another federal agency for purposes of
National Security review (35 U.S.C. 181) and for review pursuant to the Atomic Energy Act (42 U.S.C. 218(c)).

7.

A record from this system of records may be disclosed, as a routine use, to the Administrator, General Services,
or his/her designee, during an inspection of records conducted by GSA as part of that agency's responsibility to
recommend improvements in records management practices and programs, under authority of 44 U.S.C. 2904 and
2906. Such disclosure shall be made in accordance with the GSA regulations governing inspection of records for this
purpose, and any other relevant (i.e., GSA or Commerce) directive. Such disclosure shall not be used to make
determinations about individuals.

8.

A record from this system of records may be disclosed, as a routine use, to the public after either publication of
the application pursuant to 35 U.S.C. 122(b) or issuance of a patent pursuant to 35 U.S.C. 151. Further, a record
may be disclosed, subject to the limitations of 37 CFR 1.14, as a routine use, to the public if the record was filed in an
application which became abandoned or in which the proceedings were terminated and which application is
referenced by either a published application, an application open to public inspections or an issued patent.

9.

A record from this system of records may be disclosed, as a routine use, to a Federal, State, or local law
enforcement agency, if the USPTO becomes aware of a violation or potential violation of law or regulation.

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