Request for Withdrawal as Attorney or Agent and Change of Correspondence Address (Individuals or Households)

Representative and Address Provisions

Documents and Forms

Document Name Document Type
Form PTO/AIA/83 Request for Withdrawal as Attorney or Agent and Change of Correspondence Address (Individuals or Households) Form
PTO/AIA/83 Request for Withdrawal as Attorney or Agent and Change o aia0083.pdf www.uspto.gov/sites/default/files/documents/aia0083.pdf Form
PTO/SB/83 Request for Withdrawal as Attorney or Agent and Change o sb0083.pdf www.uspto.gov/sites/default/files/documents/sb0083.pdf Form

Information Collection (IC) Details

IC Title:	Request for Withdrawal as Attorney or Agent and Change of Correspondence Address (Individuals or Households)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 37 CFR 1.36(b)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	PTO/AIA/83	Request for Withdrawal as Attorney or Agent and Change of Correspondence Address	aia0083.pdf	https://www.uspto.gov/sites/default/files/documents/aia0083.pdf	Yes	Yes	Fillable Fileable Signable
Form	PTO/SB/83	Request for Withdrawal as Attorney or Agent and Change of Correspondence Address	sb0083.pdf	https://www.uspto.gov/sites/default/files/documents/sb0083.pdf	Yes	Yes	Fillable Fileable Signable

Line of Business: Economic Development

Subfunction: Intellectual Property Protection

Privacy Act System of Records
Title: Patent Application Files	FR Citation: 78 FR 19243

Number of Respondents: 66	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 66 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	105	0	105
Annual IC Time Burden (Hours)	53	32	21
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.