Form PTO/SB/57 Request for Ex Parte Reexamination Transmittal Form

PTO/SB/57 (08-13)
Approved for use through 07/31/2015. OMB 0651-0064
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.
(Also referred to as FORM PTO-1465)

REQUEST FOR EX PARTE REEXAMINATION TRANSMITTAL FORM
Address to:

Mail Stop Ex Parte Reexam
Commissioner for Patents
P.O. Box 1450
Alexandria, VA 22313-1450
1.

Date:

This is a request for ex parte reexamination pursuant to 37 CFR 1.510 of patent number _________________
issued ________________________. The request is made by:
patent owner.

2.

Attorney Docket No.:

third party requester.

The name and address of the person requesting reexamination is:
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

3.

Requester claims

small entity (37 CFR 1.27) or

micro entity status (37 CFR 1.29) – only a patent
owner requester can claim micro entity status.

4.

a.

A check in the amount of $____________ is enclosed to cover the reexamination fee, 37 CFR 1.20(c)(1);

b.

The Director is hereby authorized to charge the fee as set forth in 37 CFR 1.20(c)(1)
to Deposit Account No. ________________________;

c.

Payment by credit card. Form PTO-2038 is attached; or

d.

Payment made via EFS-Web.

5.

Any refund should be made by
check or
credit to Deposit Account No.__________________.
37 CFR 1.26(c). If payment is made by credit card, refund must be to credit card account.

6.

A copy of the patent to be reexamined having a double column format on one side of a separate paper is
enclosed. 37 CFR 1.510(b)(4).

7.

CD-ROM or CD-R in duplicate, Computer Program (Appendix) or large table
Landscape Table on CD

8.

Nucleotide and/or Amino Acid Sequence Submission
If applicable, items a. – c. are required.
a.

Computer Readable Form (CRF)

b. Specification Sequence Listing on:

c.
9.

i.

CD-ROM (2 copies) or CD-R (2 copies); or

ii.

paper

Statements verifying identity of above copies

A copy of any disclaimer, certificate of correction or reexamination certificate issued in the patent is included.

10.

Reexamination of claim(s) ____________________________________________________is requested.

11.

A copy of every patent or printed publication relied upon is submitted herewith including a listing thereof on
Form PTO/SB/08, PTO-1449, or equivalent.

12.

An English language translation of all necessary and pertinent non-English language patents and/or printed
publications is included.

[Page 1 of 2]
This collection of information is required by 37 CFR 1.510. 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 18 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: Mail Stop Ex Parte Reexam, 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.

PTO/SB/57 (08-13)
Approved for use through 07/31/2015. OMB 0651-0064
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.

13.

The attached detailed request includes at least the following items:
a. A statement identifying each substantial new question of patentability based on prior patents and printed
publications. 37 CFR 1.510(b)(1).
b. An identification of every claim for which reexamination is requested, and a detailed explanation of the pertinency
and manner of applying the cited art to every claim for which reexamination is requested. 37 CFR 1.510(b)(2).

14.

A proposed amendment is included (only where the patent owner is the requester). 37 CFR 1.510(e).

15.

a. It is certified that a copy of this request (if filed by other than the patent owner) has been served in its entirety on
the patent owner as provided in 37 CFR 1.33(c).
The name and address of the party served and the date of service are:
__________________________________________________________________________________________
__________________________________________________________________________________________
Date of Service: ___________________________________________________________; or
b. A duplicate copy is enclosed since service on patent owner was not possible. An explanation of the efforts
made to serve patent owner is attached. See MPEP § 2220.

16. Correspondence Address: Direct all communication about the reexamination to:
The address associated with Customer Number:
OR
Firm or
Individual Name ________________________________________________________________________
Address

City

State

Zip

Country
Telephone
17.

Email
The patent is currently the subject of the following concurrent proceeding(s):
a.

Copending reissue Application No.

__________________________________________________

b.

Copending reexamination Control No. __________________________________________________

c.

Copending Interference No.

d.

Copending litigation styled:

__________________________________________________

_________________________________________________________________________________
_________________________________________________________________________________
WARNING: Information on this form may become public. Credit card information should not be
included on this form. Provide credit card information and authorization on PTO-2038.
__________________________________________________
Authorized Signature

___________________________
Date

__________________________________________________
Typed/Printed Name

_____________
Registration No.

For Patent Owner Requester
For Third Party Requester

[Page 2 of 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.
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the Member with respect to the subject matter of the record.
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