Reissue Patent Application Transmittal

• Legal Form Number: AIA/50
• Court: United States Patent and Trademark Office
• Section: United States Patent and Trademark Office

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PTO/AIA/50 (10‐17)

Approved for use through 03/31/2026. OMB 0651‐0033

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.

REISSUE PATENT APPLICATION TRANSMITTAL

A

ddress to: 

Attorney Docket No.



First Named Inventor

 Mail Stop Reissue



 Commissioner for Patents Original Patent Number

 P.O. Box 1450 Original Patent Issue Date 

 Alexandria, VA 

22313‐1450 (Month/Day/Year)



   

Priority Mail Express® Label No.

APPLICATION FOR REISSUE OF:

 (Check applicable box)   Utility Patent  Design Patent  Plant Patent

APPLICATION ELEMENTS (37 CFR 1.173) ACCOMPANYING APPLICATION PARTS



1.  

Fee 

Transmittal 

Form 

(PTO/SB/56) 11.  Statement of status and support for all changes to the

 

claims. See 37 CFR 1.173(c).



2.  

Applicant 

asserts 

small 

entity status.

See 37 CFR 1.27

12.  Power of Attorney

3.  Applicant certifies micro entity status. See 37 CFR 1. 29.

Applicant must attach form PTO/SB/15A or B or equivalent. 13.  Information Disclosure Statement (IDS)

4.  Specification and Claims in double column copy of patent format  PTOSB/08 or PTO‐1449

 (amended, if appropriate) Copies of citations attached

5.  Drawing(s) (proposed amendments, if appropriate)14.  English translation of Reissue Oath/Declaration

6.  Reissue Oath/Declaration or Substitute Statement  (if applicable)

 (37 CFR 1.175) (PTO/AIA/05, 06, or 07) 15.  Return Receipt Postcard (MPEP § 503)

7.  Application Data Sheet NOTE: Benefit claims under 37 CFR 1.78  (Should be specifically itemized)

 and foreign priority claims under 37 CFR 1.55 MUST be set forth in an 16.  Preliminary Amendment (37 CFR 1.173; MPEP § 1453)

 Application Data Sheet (ADS). 

8.  Original U.S. Patent currently assigned?  Yes  No 17. Other: ____________________________________________

(If Yes, check applicable box(es))__________________________________ ________________

 Written Consent of all Assigness (PTO/AIA/53) _________________________________________ _________

 37 CFR 3.73(c) Statement (PTO/AIA/96) __________________________________________________

9.  CD‐ROM or 

CD‐R in duplicate, Computer Program (Appendix) or large __________________________________________________

 

table

__________________________________________________ 

 Landscape Table on CD

10. Nucleotide and/or Amino Acid Sequence Submission __________________________________ ________________

(if applicable, items a. – c. are required)

 a.  Computer Readable Form (CRF)  

This 

is 

a continuation



reissue 

or 

divisional 

reissue 

application

 b.  Specification Sequence Listing on:  

(i.e., 

a second



or 

subsequent reissue

application



for 

the 

same

issued

patent).



(Check 

box 

if 

applicable.)

 i. CD‐ROM (2 copies) or CD‐R (2 copies); or

ii. Pap er

 c.  Statements verifying identity of above copies

18. CORRESPONDENCE ADDRESS

 The address associated with Customer Number: __________________________________  OR  Correspondence address below

Name

Address

City State Zip Code

Country Telephone

Email

Signature Date 



Name (Print/Type)



Registration No. 

                               

                          

                      

                         

                      

            

             

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