Power to Inspect/Copy - For Applications Filed on or after September 16, 2012

• Legal Form Number: AIA/67
• Court: United States Patent and Trademark Office
• Section: United States Patent and Trademark Office

I

□

□

□

□

□

PTO/AIA/67 (11-15)

Approved for use through 12/31/2020. 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.

________________________________________

_____

___

____________________

__________________

___________________________

___

________________________________________

________

_______________________________________

______

___

_____________________________________

_____

______

POWER TO INSPECT/COPY

-

FOR APPLICATIONS FILED

ON OR AFTER

SEPTEMBER 16, 2012

First Named

Inventor

Application

Number

Title

Art Unit

Examiner

Docket

Number

Filed

Commissioner for Patents

P.O. Box 1450

Paper No.

_______________

Alexandria, VA 22313

-

1450

Please permit the following person(s) to inspect and make copies of the above-identified application:

Customer Name(s):

______________________________________________

Badge Number(s):

______________________________________________

Company Name (if any):

__________________________________________

Telephone Number:

___________________

_____________________

______

Fax Number:

_____________________________________________

______

I am

(pursuant to 37 CFR 1.14(c))

:



t

he

a

pplicant.

a

patent practitioner of

record. Registration No.

_________________________.

.

an authorized official of the assignee or an assignee of an undivided part interest. The assignment was made of

record pursuant to 37 CFR 3.71 in the United States Patent and Trademark Office at Reel

____________________

Frame____________________________

, or for which a copy thereof is attached.

t

he inventor or a joint inventor.

a

registered

a

ttorney or agent named in the

papers accompanying the

application papers filed under

37 CFR 1.53 or

the

national stage documents filed under 37 CFR

1.495

. A

power of attorney has not been appointed under 37 CFR 1.32

.

Registration No.

_____________

.

.

Signature

Date

Typed or Printed Name

Title (Officer of company or corporate assignee)

Name of Assignee, if any (e.g., company name)

Telephone

Number

FOR USPTO USE ONLY

If a CD is ordered:

Date CD ordered:

______________________

Date CD received:

______________________

Date CD given to customer:

_______________

Date CD returned by customer:

____________

CD purchased? YES NO

Power to Inspect Approved by:

______________________________________

_

Unit:

___________________________________

This collection of information is required by 37 CFR 1.14. 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 12

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.