PTO/AIA/08 Declaration for Utility or Design Application (37 CFR 1.

Doc Code: Oath
Document Description: Oath or declaration filed

PTO/AIA/08 (11-15)
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 contains a valid OMB control number.

DECLARATION FOR UTILITY OR
DESIGN
PATENT APPLICATION
(37 CFR 1.63)

Attorney Docket
Number
First Named Inventor
COMPLETE IF KNOWN
Application Number

Declaration
Submitted
With Initial
Filing

Declaration
Submitted After Initial
Filing (surcharge
(37 CFR 1.16(f))
required)

OR

Filing Date
Art Unit
Examiner Name

(Title of the Invention)
As a below named inventor, I hereby declare that:
This declaration is directed to:
The attached application,
OR
United States Application Number or PCT International application number

filed on

.

The above-identified application was made or authorized to be made by me.
I believe I am the original inventor or an original joint inventor of a claimed invention in the application.
I hereby acknowledge that any willful false statement made in this declaration is punishable under 18 U.S.C. 1001
by fine or imprisonment of not more than five (5) years, or both.

Direct all
correspondence to:

The address

Correspondence

associated with
Customer Number:

OR

address below

Name

Address

City

Country

State

Telephone

Zip

Email

[Page 1 of 2]
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If you need assistance in completing the form, call 1-800-PTO-9199 and select option 2.

PTO/AIA/08 (11-15)

Approved for use through 05/31/2024. 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 contains a valid OMB control number.

DECLARATION — Utility or Design Patent Application

WARNING:
Petitioner/applicant is cautioned to avoid submitting personal information in documents filed in a patent application that may
contribute to identity theft. Personal information such as social security numbers, bank account numbers, or credit card numbers
(other than a check or credit card authorization form PTO-2038 submitted for payment purposes) is never required by the USPTO
to support a petition or an application. If this type of personal information is included in documents submitted to the USPTO,
petitioners/applicants should consider redacting such personal information from the documents before submitting them to the
USPTO. Petitioner/applicant is advised that the record of a patent application is available to the public after publication of the
application (unless a non-publication request in compliance with 37 CFR 1.213(a) is made in the application) or issuance of a
patent. Furthermore, the record from an abandoned application may also be available to the public if the application is referenced
in a published application or an issued patent (see 37 CFR 1.14). Checks and credit card authorization forms
PTO-2038 submitted for payment purposes are not retained in the application file and therefore are not publicly available.
Petitioner/applicant is advised that documents which form the record of a patent application (such as the PTO/SB/01) are placed
into the Privacy Act system of records DEPARTMENT OF COMMERCE, COMMERCE-PAT-7, System name: Patent Application
Files . Documents not retained in an application file (such as the PTO-2038) are placed into the Privacy Act system of
COMMERCE/PAT-TM-10, System name: Deposit Accounts and Electronic Funds Transfer Profiles.

LEGAL NAME OF SOLE OR FIRST INVENTOR:

(E.g., Given Name (first and middle if any) and Family Name or Surname)

Inventor's Signature

Residence: City

Date (Optional)

State

Country

State

Zip

Mailing Address

City

Additional inventors are being named on the

[Page 2 of 2]

Country

Supplemental sheet(s) PTO/AIA/10 attached hereto

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.