PTO/AIA/47 "Fee Address" Indication Form

Doc Code: MFEE.C.AD
Document Description: Maintenance Fee Address Change

PTO/AIA/47 (12-20)
Approved for use through XX/XX/20XX. OMB 0651-0016
U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
Under the Paperwork Reduction Act of 1995, no person is required to respond to a collection of information unless it displays a valid OMB control number.

“FEE ADDRESS” INDICATION FORM
Address to:
Mail Stop Maintenance Fee
Director of the United States
Patent and Trademark Office
P.O. Box 1450
Alexandria, VA 22313-1450

Fax to:
571-273-6500

-OR-

INSTRUCTIONS: The issue fee must have been paid for the application(s) listed on this form. In addition, only an address
represented by a Customer Number can be established as the fee address for maintenance fee purposes (hereafter, fee
address). A fee address should be established when correspondence related to maintenance fees should be mailed to a
different address than the correspondence address for the application.
When to check the first box below: If you have a Customer Number to represent the fee address.
When to check the second box below: If you have no Customer Number representing the desired fee address, in which case
a completed Request for Customer Number (PTO/SB/125) must be attached to this form. For more information on Customer
Numbers, see the Manual of Patent Examining Procedure (MPEP) § 403.
For the following listed application(s), please recognize as the “Fee Address” under the provisions of 37 CFR 1.363 the
address associated with:
Customer Number:
OR
The attached Request for Customer Number form (PTO/SB/125)
PATENT NUMBER
(if known)

APPLICATION NUMBER

Completed by (check one):
Applicant/Inventor
Attorney or Agent of record _______________
Reg. No.
Assignee of record of the entire interest. See
37 CFR 3.71. Statement under 37 CFR 3.73(c)
(Form PTO/AIA/96) is enclosed or was filed on
______________________________________
(Date)

_________________________________________________
Signature
_________________________________________________
Typed or printed name
_________________________________________________
Requester’s telephone number
_________________________________________________
Date

NOTE: Signatures of all the inventors or assignees of record of the entire interest or their representative(s) are required. If the assignee is a
juristic entity, this form must be signed by a patent practitioner (attorney or agent) of record. Submit multiple forms if more than one
signature is required, see below*.

*Total of ___________________ forms are submitted
TA Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with an
information collection subject to the requirements of the Paperwork Reduction Act of 1995, unless the information collection has a currently valid OMB Control
Number. The OMB Control Number for this information collection is 0651-0016. Public burden for this form is estimated to average 5 minutes per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the
information collection. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this
burden to the Chief Administrative Officer, United States Patent and Trademark Office, P.O. Box 1450, Alexandria, VA 22313-1450 or email
[email protected]. 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. The United States Patent and
Trademark Office (USPTO) collects this information under authority of 37 CFR 1.33. The information in this
system of records is used to manage all records of applicant including name, citizenship, residence, post office
address and other information with respect to inventors and their legal representatives pertaining to the
applicant's activities in connection with the invention for which a patent is sought. This information is protected
from disclosure to third parties in accordance with the Privacy Act.
However, routine uses of this information may include disclosure to the following: to law enforcement and
investigation in the event that the system of records indicates a violation or potential violation of law; to a
Federal, state, local, or international agency, in response to its request; to an agency, organization, or individual
for the purpose of performing audit or oversight operations as authorized by law; to non-federal personnel under
contract to the agency; to a court for adjudication and litigation; to the Department of Justice for Freedom of
Information Act (FOIA) assistance; to members of congress working on behalf of an individual; to the Office of
Personnel Management (OPM) for personnel research purposes; to National Archives and Records
Administration for inspection of records; and to the Office of Management and Budget (OMB) for legislative
coordination and clearance. Failure to provide any part of the requested information may result in an inability to
process requests for access and information. The applicable Privacy Act System of Records Notice for this
information is COMMERCE/PAT-TM-7 Patent Application Files, available at Federal Register / Vol. 78, No. 61 /
Friday, March 29, 2013 /Notices 19243. https://www.govinfo.gov/content/pkg/FR-2013-03-29/
pdf/2013-07341.pdf