Disclaimer in a Patent under 37 CFR 1.321(a)

Legal Form NumberSB/43
CourtUnited States Patent and Trademark Office, Patent Trial and Appeal Board
SectionUnited States Patent and Trademark Office
Document Description: Statutory Disclaimers per Manual of Patent Examining Procedure(MPEP) 1490 PTO/SB/43 (06-23)
Approved for use through 05/31 /2024. OMB 0651-0031
U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
Under the Paperwork R eduction Act of 1995, no persons are required to respond to a collectio n of information unless it displays a valid OMB c ontrol number.
Name of Patentee
Docket Number (optional)
Patent Number
Date Patent Issued
Title of Invention
Patentee hereby disclaims:
the following complete claim(s) in the above-identi fied patent: ___________________________ ___.
the terminal part of the term o f the above-identified patent beginning on the date: ______________.
the entire term of the above-identified patent.
The disclaimer is binding on the patentee and its successors or assigns.
The extent of patentee’s ownership interest in the above-identified patent is : ___________________________.
The fee for this disclaimer is s et forth in 37 CFR 1.20(d) and is being paid in the following manner:
payment by the USPTO’s patent electronic filing system (Patent Center or EFS-Web).
the Director is hereby authorized to charge any fees which may be required, or credit any
overpayment, to Deposit Account No. _________________ _.
payment by credit card. Form PTO-2038 is attached.
a check in the amount of the fee is enclosed.
WARNING: Information on this form may become public. Credit card information should not be included on this
form. Provide credit card information and authorization on form PTO-2038.
The undersigned is:
patentee. If patentee is a juristic entity, the undersigned is authorized to act on behalf of the juristic
attorney or agent of record.
Name (printed/typed)
Practitioner registration number
Note: See 37 CFR 1.4(d) for signature requirements and certifications.
A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to
comply with an information collection subject to the requirements of the Paperwork Reduction Act of 1995, unles s the information collection has
a currently valid OMB Control Number. The OMB Control Number for this information collection is 0651-0031. Public burden for this form is
estimated to average 12 minutes per response, including the time for reviewing instructions, searching exis ting data sources, gathering and
maintaining the data needed, and completing and reviewing the information collection. Send com ments regarding this burden estimate or any
other aspect of this information collection, including suggestions for reducing this burden to the Chief Administrative Officer, Unit ed States Patent
and Trademark Office, P.O. Box 1450, Alexandria, VA 22313-1450 or ema il InformationCollection@uspto.gov. DO NOT SEND FE ES OR COMPLETED
FORMS TO THIS ADDRESS. If filing the completed form by mail, send to: Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313-1450.
If you need assistance in completing t he form, call 1-800-PTO-9199 and select option 2.

To continue reading

Request your trial

VLEX uses login cookies to provide you with a better browsing experience. If you click on 'Accept' or continue browsing this site we consider that you accept our cookie policy. ACCEPT