Form PTO/SB/81C Reexamination – Third Party Requester Power of Attorney

PTO/SB/81C (12-08)
Approved for use through XX/XX/XXXX. OMB Control Number 0651-0035
U.S. Patent and Trademark Office; 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.

REEXAMINATION - THIRD PARTY REQUESTER
POWER OF ATTORNEY OR
REVOCATION OF POWER OF ATTORNEY WITH
A NEW POWER OF ATTORNEY
AND
CHANGE OF CORRESPONDENCE ADDRESS

Control Number(s)
Filing Date(s)
First Named Inventor
Title
Patent Number
Examiner Name
Attorney Docket No(s).

I hereby revoke all previous requester powers of attorney given in the above-identified reexamination proceeding control number(s).

A Power of Attorney is submitted herewith.
OR

OR

I hereby appoint Practitioner(s) associated with the following Customer Number as my/our
attorney(s) or agent(s) to prosecute the proceeding(s) identified above, and to transact all
business in the United States Patent and Trademark Office connected therewith:
I hereby appoint Practitioner(s) named below as my/our attorney(s) or agent(s) to prosecute the proceeding(s)
identified above, and to transact all business in the United States Patent and Trademark Office connected therewith:
Practitioner(s) Name

Registration Number

Please recognize or change the correspondence address for the above-identified reexamination proceeding control number(s)
(more than one may be changed only if they are merged proceedings) to be:
The address associated with the above-mentioned Customer Number.

OR
The address associated with Customer Number:

OR
Firm or
Individual Name
Address
City

State

Zip

Country
Telephone

Email

I am the third party requester.
Proof of authority to act on behalf of requester submitted herewith or filed on

.

SIGNATURE of Third Party Requester

Signature
Name

Date
Telephone

Title and Company
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If you need assistance in completing the form, call 1-800-PTO-9199 and select option 2.
If you need assistance in completing the form, call 1-800-PTO-9199 and select option 2.

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