(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
The
address
Correspondence
correspondence to:
associated with
OR
address below
Customer Number:
Name
Address
City
Zip
Country
Telephone
Email
Doc Code: Oath
PTO/AIA/08 (11-15)
Document Description: Oath or declaration filed
Approved for use through 11/30/2020. 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.
Attorney Docket
DECLARATION FOR UTILITY OR
Number
DESIGN
First Named Inventor
PATENT APPLICATION
COMPLETE IF KNOWN
(37 CFR 1.63)
Application Number
Declaration Declaration
Filing Date
Submitted Submitted After Initial
With Initial OR Filing (surcharge
Art Unit
Filing (37 CFR 1.16(f))
required)
Examiner Name
[Page 1 of 2]
This collection of information is required by 35 U.S.C. 115 and 37 CFR 1.63. 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 21 minutes to
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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.
PTO/AIA/08 (11-15)
Approved for use through 11/30/2020. 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
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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
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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
Date (Optional)
Residence:
City
Country
Mailing
Address
City
Zip
Country
Additional inventors are being named on the Supplemental sheet(s) PTO/AIA/10 attached hereto
[Page 2 of 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,
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potential violation of law or regulation.