Form PTO/SB/123A Patent Owner Change of Correspondence Address - Reexamin

Representative and Address Provisions

sb0123a

Patent Owner Change of Correspondence Address - Reexamination Proceeding

OMB: 0651-0035

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PTO/SB/123A (02-09)
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.

PATENT OWNER CHANGE OF
CORRESPONDENCE ADDRESS
Reexamination Proceeding
Address to:
Commissioner for Patents
P.O. Box 1450
Alexandria, VA 22313-1450

Control Number(s)
Filing Date(s)
First Named Inventor
Art Unit
Examiner Name
Attorney Docket Number(s)

Please change the patent owner's correspondence address in the above-identified reexamination proceeding control no(s).
(more than one may be changed only if they are merged proceedings) to the address designated below in A or B.
AND
Pursuant to 37 CFR 1.33(c), a PTO/SB/123 has been filed, or is concurrently being filed, in Patent No.
(the subject of the above-identified reexam proceeding control no(s).) to make the same address change in the patent.
A correspondence address change will not be entered in a reexamination, unless the same change is made in the
patent. To insure prompt action on the request, form PTO/SB/123 (if not already submitted) must be included together
with this form.
NOTE: Address change can only be made by party of record; if not of record - see PTO/SB/81A and PTO/SB/81B.
The address associated with
Customer Number:

A.
OR

Firm or individual name

B.

Address
City

State

Zip

Country
Telephone

Email

This form cannot be used to change the data associated with a Customer Number. To change the data associated with an
existing Customer Number use "Request for Customer Number Data Change" (PTO/SB/124).
I am the:
1.

Attorney or agent of record for patent owner, Registration No.
OR

2.

Patent owner acting pro se (PTO/SB/96 is required for an entity which is not individual person(s))

Signature
Typed or Printed
Name

Telephone

Date

NOTE: Signatures of all the patent owners or their representatives 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 1.33. 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.

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File Typeapplication/pdf
AuthorUSPTO
File Modified2009-02-26
File Created2009-02-25

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