Fillable Approved for use through 11/30/2020. OMB 0651-0031 U.S. (USPTO)

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Approved for use through 11/30/2020. OMB 0651-0031 U.S. (USPTO)

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Doc Code:
PD.TO.AUTH
Document Description:
Auth or Resc of Auth to Access Appl by DAS/PDX Office
PTO/SB/39 (11-15)
Approved for use through 11/30/2020. OMB 0651-0031
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.
AUTHORIZATION OR RESCISSION OF AUTHORIZATION TO
PERMIT ACCESS TO APPLICATION
-
-
FILED BY PARTICIPATING OFFICES
Send completed form to: Commissioner for Patents
P.O. Box 1450, Alexandria, VA 22313
-
Application Number
(if known)
:
Filing Date
:
First Named Inventor:
Attorney Docket Number
:
Title (Required)
Check either box 1 or 2 below, but not both:
1.
By checking this box, the undersigned hereby grants the USPTO authority to provide the European
Patent Office (EPO), the Japan Patent Office (JPO), the Korean Intellectual Property Office (KIPO),
the
State
Intellectual Property Office of the People’s Republic of China (SIPO), the World Intellectual Property
O
rganization
(WIPO), and any other foreign intellectual property office participating with the USPTO in a bilateral
or multilateral priority document exchange agreement in which a foreign application claiming priority to the instant
patent application is filed, access
to: (1) the instant patent application
-
as
-
filed and its related bibliographic data,
(2) any foreign or domestic application to which priority or benefit is claimed by the instant application and its
related bibliographic data, and (3) the date of filing o
f this Authorization. See 37 CFR 1.14(h)(1).
2.
By checking this box, the undersigned hereby rescinds the previous authority granted to the USPTO to
provide the EPO, JPO, KIPO, SIPO, WIPO or any other foreign intellectual property office partici
pating with the
USPTO in a bilateral or multilateral priority document exchange agreement access to the
documents and
information identified in paragraph 1 above
.
This rescission of the previous authorization will not be effective unless and until an app
ropriate USPTO official
recognizes and acts on the rescission.
However, o
nce the application has published or is otherwise publicly available, the USPTO may provide
access to the application in accordance with 37 CFR 1.14.
NOTE: This form must be signed by an authorized party in accordance with 37 CFR 1.14(c). Please see 37 CFR 1.4(d)
for the form of the signature. If necessary, submit multiple forms for more than one signature, see below.*
Signature
Date
Name
(Print/Typed)
Practitioner
Registration Number
(If applicable)
Name of Assignee
(
if applicable
)
Title
(
if applicable
)
*Total of
______
forms are submitted.
This collection of information is required by 37 CFR 1.14(h). The information is required to obtain or retain a benefit by the public which is to file (and by the
USPTO to process) an application. Confidentiality is governed by 35 U.S.C. 122 and 37 CFR 1.11 and 1.14. This collection is estimated to take 6 minutes to
complete, including gathering, preparing, and submitting the completed application form to the USPTO. Time will vary depending upon the individual case. Any
comments on the amount of time you require to complete this form and/or suggestions for reducing this burden, should be sent to the Chief Information Officer,
U.S. Patent and Trademark Office, U.S. Department of Commerce, P.O. Box 1450, Alexandria, VA 22313-1450. 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. Accordingly, pursuant to the requirements of the Act,
please be advised that: (1) the general authority for the collection of this information is 35 U.S.C. 2(b)(2); (2) furnishing of
the information solicited is voluntary; and (3) the principal purpose for which the information is used by the U.S. Patent
and Trademark Office is to process and/or examine your submission related to a patent application or patent. If you do
not furnish the requested information, the U.S. Patent and Trademark Office may not be able to process and/or examine
your submission, which may result in termination of proceedings or abandonment of the application or expiration of the
patent.
The information provided by you in this form will be subject to the following routine uses:
1.
The information on this form will be treated confidentially to the extent allowed under the Freedom of Information
Act (5 U.S.C. 552) and the Privacy Act (5 U.S.C 552a). Records from this system of records may be disclosed to
the Department of Justice to determine whether disclosure of these records is required by the Freedom of
Information Act.
2.
A record from this system of records may be disclosed, as a routine use, in the course of presenting evidence to
a court, magistrate, or administrative tribunal, including disclosures to opposing counsel in the course of
settlement negotiations.
3.
A record in this system of records may be disclosed, as a routine use, to a Member of Congress submitting a
request involving an individual, to whom the record pertains, when the individual has requested assistance from
the Member with respect to the subject matter of the record.
4.
A record in this system of records may be disclosed, as a routine use, to a contractor of the Agency having need
for the information in order to perform a contract. Recipients of information shall be required to comply with the
requirements of the Privacy Act of 1974, as amended, pursuant to 5 U.S.C. 552a(m).
5.
A record related to an International Application filed under the Patent Cooperation Treaty in this system of
records may be disclosed, as a routine use, to the International Bureau of the World Intellectual Property
Organization, pursuant to the Patent Cooperation Treaty.
6.
A record in this system of records may be disclosed, as a routine use, to 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)).
7.
A record from this system of records may be disclosed, as a routine use, to the Administrator, General Services,
or his/her designee, during an inspection of records conducted by GSA as part of that agency’s responsibility to
recommend improvements in records management practices and programs, under authority of 44 U.S.C. 2904
and 2906. Such disclosure shall be made in accordance with the GSA regulations governing inspection of
records for this purpose, and any other relevant (
i.e.
, GSA or Commerce) directive. Such disclosure shall not be
used to make determinations about individuals.
8.
A record from this system of records may be disclosed, as a routine use, to the public after either publication of
the application pursuant to 35 U.S.C. 122(b) or issuance of a patent pursuant to 35 U.S.C. 151. Further, a
record may be disclosed, subject to the limitations of 37 CFR 1.14, as a routine use, to the public 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 inspection or an issued
patent.
9.
A record from this system of records may be disclosed, as a routine use, to a Federal, State, or local law
enforcement agency, if the USPTO becomes aware of a violation or potential violation of law or regulation.
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Approved for use through 11302020. OMB 0651-0031 U.S. (USPTO)

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Completed 17 July 2021

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