Form PTO/SB/81A Patent - Power of Attorney or Revocation of Power of Att

Representative and Address Provisions

sb0081a

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

OMB: 0651-0035

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PTO/SB/81A (12-08)
Approved for use through 11/30/2011. OMB 0651-0035
U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
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PATENT - POWER OF ATTORNEY
OR
REVOCATION OF POWER OF ATTORNEY
WITH A NEW POWER OF ATTORNEY
AND
CHANGE OF CORRESPONDENCE ADDRESS

Patent Number
Issue Date
First Named Inventor
Title
Attorney Docket Number

I hereby revoke all previous powers of attorney given in the above-identified patent.
A Power of Attorney is submitted herewith.
OR

OR

I hereby appoint Practitioner(s) associated with the following Customer Number as my/our
attorney(s) or agent(s) with respect to the patent identified above, and to transact all business in
the United States Patent and Trademark Office connected therewith:
I hereby appoint Practitioner(s) named below as my/our attorney(s) or agent(s) with respect to the patent 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 patent 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:
Inventor, having ownership of the patent.

OR

Patent owner.
Statement under 37 CFR 3.73(b) (Form PTO/SB/96) submitted herewith or filed on ______________________________.
SIGNATURE of Inventor or Patent Owner

Signature
Name

Date
Telephone

Title and Company
NOTE: Signatures of all the inventors or patent owners 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.
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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.

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File Typeapplication/pdf
AuthorUSPTO
File Modified2008-12-23
File Created2008-10-27

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