PTO/SB/81 Power of Attorney or Revocation of Power of Attorney wit

Representative and Address Provisions

sb0081

Power of Attorney or Revocation of Power of Attorney with a New Power of Attorney and Change of Correspondence Address

OMB: 0651-0035

Document [pdf]
Download: pdf | pdf
PTO/SB/81 (01-09)
Approved for use through 11/30/2011. OMB 0651-0035
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 a valid OMB control number.

POWER OF ATTORNEY
OR
REVOCATION OF POWER OF ATTORNEY
WITH A NEW POWER OF ATTORNEY
AND
CHANGE OF CORRESPONDENCE ADDRESS

Application Number
Filing Date
First Named Inventor
Title
Art Unit

Examiner Name
Attorney Docket Number

I hereby revoke all previous powers of attorney given in the above-identified application.
A Power of Attorney is submitted herewith.
OR
I hereby appoint Practitioner(s) associated with the following Customer
Number as my/our attorney(s) or agent(s) to prosecute the application
identified above, and to transact all business in the United States Patent
and Trademark Office connected therewith:
OR
I hereby appoint Practitioner(s) named below as my/our attorney(s) or agent(s) to prosecute the application identified above, and
to transact all business in the United States Patent and Trademark Office connected therewith:
Practitioner(s) Name

Registration Number

Please recognize or change the correspondence address for the above-identified application to:
The address associated with the above-mentioned Customer Number.
OR
The address associated with Customer Number:
OR
Firm or
Individual Name
Address
City

State

Zip

Country
Telephone

Email

I am the:
Applicant/Inventor.
OR
Assignee of record of the entire interest. See 37 CFR 3.71.
Statement under 37 CFR 3.73(b) (Form PTO/SB/96) submitted herewith or filed on ______________________________.
SIGNATURE of Applicant or Assignee of Record
Signature

Date

Name

Telephone

Title and Company
NOTE: Signatures of all the inventors or assignees of record of the entire interest or their representative(s) are required. Submit multiple forms if more than one
signature is required, see below*.

*Total of ____________ forms are submitted.
This collection of information is required by 37 CFR 1.31, 1.32 and 1.33. 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 3 minutes 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. SEND TO: Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313-1450.

If you need assistance in completing the form, call 1-800-PTO-9199 and select option 2.

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 disclosure of these records is required by the Freedom of Information Act. 

2.	 A record from this system of records may be disclosed, as a routine use, in the course of
presenting evidence to a court, magistrate, or administrative tribunal, including disclosures
to opposing counsel in the course of settlement negotiations.
3.	 A record in this system of records may be disclosed, as a routine use, to a Member of
Congress submitting a 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.
4.	 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 inspection 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. 



File Typeapplication/pdf
AuthorUSPTO
File Modified2009-08-27
File Created2009-02-20

© 2024 OMB.report | Privacy Policy