PTO/AIA/15 Utility Patent Application Transmittal

PTO/AIA/15  (10-17) 
Approved  for  use  through  XX/XX/XXXX.  OMB  0651-0032 
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. 

UTILITY 
PATENT APPLICATION 
TRANSMITTAL 

Attorney Docket No. 
First Named Inventor 
Title 
Priority Mail Express®

Label No.

(Only for new nonprovisional applications under 37 CFR 1.53(b)) 

APPLICATION ELEMENTS 
See MPEP chapter 600 concerning utility patent application contents. 

1.          Fee Transmittal Form 
             (PTO/SB/17 or equivalent) 

ADDRESS TO: 

Commissioner for Patents 
P.O. Box 1450 
Alexandria, VA  22313‐1450 

ACCOMPANYING APPLICATION PAPERS 
10.          Assignment Papers 
               (cover sheet & document(s)) 
                                   Name of Assignee ___________________________ 

2.          Applicant asserts small entity status. 
             See 37 CFR 1.27 
3.          Applicant certifies micro entity status. See 37 CFR 1.29. 
             Applicant must attach form PTO/SB/15A or B or equivalent. 

                                   __________________________________________ 

4.          Specification                                  [Total Pages ____________] 
             Both the claims and abstract must start on a new page. 
             (See MPEP § 608.01(a) for information on the preferred arrangement) 

11.          37 CFR 3.73(c) Statement                                Power of Attorney 
                  (when there is an assignee) 

5.          Drawing(s) (35 U.S.C. 113)          [Total Sheets ____________] 

12.          English Translation Document 
                (if applicable) 

6.  Inventor’s Oath or Declaration          [Total Pages ____________] 
     (including substitute statements under 37 CFR 1.64 and assignments 

13.          Information Disclosure Statement 
                (PTO/SB/08 or PTO‐1449) 

      serving as an oath or declaration under 37 CFR 1.63(e)) 

                               Copies of citations attached 

      a.          Newly executed (original or copy) 

14.          Preliminary Amendment 

      b.          A copy from a prior application (37 CFR 1.63(d)) 

15.          Return Receipt Postcard 
                (MPEP § 503) (Should be specifically itemized) 

7.          Application Data Sheet     * See note below. 
             See 37 CFR 1.76 (PTO/AIA/14 or equivalent) 

16.          Certified Copy of Priority Document(s) 
                (if foreign priority is claimed) 

8.          CD‐ROM or CD‐R 
              in duplicate, large table, or Computer Program (Appendix) 

17.          Nonpublication Request 
                Under 35 U.S.C. 122(b)(2)(B)(i). Applicant must attach form PTO/SB/35 
                or equivalent. 

                    Landscape Table on CD 
9.  Nucleotide and/or Amino Acid Sequence Submission 
     (if applicable, items a. – c. are required) 

18.          Other: _____________________________________________ 

      a.          Computer Readable Form (CRF) 

                            _____________________________________________ 

      b.          Specification Sequence Listing on: 

                            _____________________________________________ 

             i.          CD‐ROM or CD‐R (2 copies); or 

                            _____________________________________________ 

             ii.         Paper 

                            _____________________________________________ 

      c.          Statements verifying identity of above copies 
*Note:  (1) Benefit claims under 37 CFR 1.78 and foreign priority claims under 1.55 must be included in an Application Data Sheet (ADS). 
              (2) For applications filed under 35 U.S.C. 111, the application must contain an ADS specifying the applicant if the applicant is an 
                    assignee, person to whom the inventor is under an obligation to assign, or person who otherwise shows sufficient proprietary 
                    interest in the matter. See 37 CFR 1.46(b). 

19. CORRESPONDENCE ADDRESS 
          The address associated with Customer Number: __________________________________        OR             Correspondence address below 
Name 

Address 

City 

State 

Zip Code 

Country 

Telephone 

Email 

Signature 
Name 
(Print/Type) 

Date 
Registration No.
(Attorney/Agent) 

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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 the information in this record under authority of 35 U.S.C. 2. The USPTO’s
system of records is used to manage all applicant and owner information including name, citizenship,
residence, post office address, and other information with respect to inventors and their legal representatives
pertaining to the applicant's/owner’s activities in connection with the invention for which a patent is sought or
has been granted. The applicable Privacy Act System of Records Notice for the information collected in this
form is COMMERCE/PAT-TM-7 Patent Application Files, available in the Federal Register at 78 FR 19243
(March 29, 2013). https://www.govinfo.gov/content/pkg/FR-2013-03-29/pdf/2013-07341.pdf
Routine uses of the information in this record may include disclosure to: 1) law enforcement, in the event that
the system of records indicates a violation or potential violation of law; 2) a Federal, state, local, or international
agency, in response to its request; 3) a contractor of the USPTO having need for the information in order to
perform a contract; 4) the Department of Justice for determination of whether the Freedom of Information Act
(FOIA) requires disclosure of the record; 5) a Member of Congress submitting a request involving an individual
to whom the record pertains, when the individual has requested the Member’s assistance with respect to the
subject matter of the record; 6) a court, magistrate, or administrative tribunal, in the course of presenting
evidence, including disclosures to opposing counsel in the course of settlement negotiations; 7) the
Administrator, General Services Administration (GSA), or their designee, during an inspection of records
conducted by GSA under authority of 44 U.S.C. 2904 and 2906, in accordance with the GSA regulations and
any other relevant (i.e., GSA or Commerce) directive, where such disclosure shall not be used to make
determinations about individuals; 8) another federal agency for purposes of National Security review (35 U.S.C.
181) and for review pursuant to the Atomic Energy Act (42 U.S.C. 218(c)); 9) the Office of Personnel
Management (OPM) for personnel research purposes; and 9) the Office of Management and Budget (OMB) for
legislative coordination and clearance.
If you do not furnish the information requested on this form, the USPTO may not be able to process and/or
examine your submission, which may result in termination of proceedings, abandonment of the application,
and/or expiration of the patent.

Additional Uses
Additional USPTO uses of the information in this record may include disclosure to: 1) the International Bureau
of the World Intellectual Property Organization, if the record is related to an international application filed under
the Patent Cooperation Treaty; 2) the public i) after publication of the application pursuant to 35 U.S.C. 122(b),
ii) after issuance of a patent pursuant to 35 U.S.C. 151, iii) if the record was filed in an application which
became abandoned or in which the proceedings were terminated and which application is referenced by either
a published application, an application open to public inspections, or an issued patent, or iv) without publication
of the application or patent under the specific circumstances provided for by 37 CFR 1.14(a)(1)(v)-(vii); and/or
3) the National Archives and Records Administration, for inspection of records.