"Fee Address" Indication Form

• Legal Form Number: AIA/47
• Court: United States Patent and Trademark Office
• Section: United States Patent and Trademark Office

Doc Code: MFEE.C.AD

Document Description: Maintenance Fee Address C hange

PTO/AIA/47 (11-21)

Approved for use through 11/30/2024. OMB 0651-0016

U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE

Under the Paperwork Re duction Act of 1995, no person is required to respond to a c ollection of information unle ss it displays a valid OMB co ntrol number.

“FEE ADDRESS” INDICATION FORM

Address to:

Mail Stop Maintenance Fee Fax to:

Director of the United States -OR-571-273-6500

Patent and Trademark Office

P.O. Box 1450

Alexandria, VA 22313-1450

INSTRUCTIONS: The issue fee mu st have been paid for the application(s) listed on thi s form. In addition, only an address

represented by a Customer Number can be esta blished as the fee address for maintenance fee purposes (hereafter, fee

address). A fee address should be est ablished when correspondence related to maintenance f ees should be mailed to a

different address than the correspo ndence address for the application.

When to check the first box below: If you have a Customer Number to represent the fee address.

When to check the second box below: If you have no Custom er Number representing the desired fee address, in which case

a completed Request for Customer Number (PT O/SB/125) must be attached to this form. For more information on Customer

Numbers, see the Manual of Patent E xamining Procedure (MPEP) § 403.

For the following listed application(s) , please recognize as the “Fee Address” under the provisions of 37 CFR 1.363 the

address associated with:

Customer Number:

OR

The attached Request for Custom er Number form (PTO/SB/125)

PATENT NUMBER

(if known) APPLICATION NUMBER

Completed by (check one):

_______________________________ __________________

Applicant/Inventor

Signature

Attorney or Agent of record _______________ _______________________________ __________________

Reg. No.

Typed or printed name

Assignee of record of the entire interest. Se e

37 CFR 3.71. Statement under 37 CFR 3.73(c) _______________________________ __________________

(Form PTO/AIA/96) is enclosed or was filed on Requester’s telephone numb er

_______________________________ _______

(Date)

_______________________________ __________________

Date

NOTE: Signatures of all the inventors or assignees of record of the entire interest or their representative(s) are required. If the assignee is a

juristic entity, this form must be signed by a patent practitione r (attorney or agent) of record. Submit multiple forms if more than one

signature is required, see below*.

*Total of ___________________ f orms are submitted

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, unless the information collection has a currently valid OMB Control

Number. The OMB Control Number for this information collection is 0651-0016. Public burden for this form is estimated to average 5 minutes per response,

including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the

information collection. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this

burden to the Chief Administrative Officer, United States Patent and Trademark Office, P.O. Box 1450, Alexandria, VA 22313-1450 or

email InformationCollection@uspto.gov. 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.