Form Pto/aia/80 - Power Of Attorney To Prosecute Applications Before The Uspto

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PTO/AIA/80 (07-17)
Approved for use through 01/31/2018. OMB 0651-0035
U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
Under the Paperwork Reduction Act of 1995, no person is required to respond to a collection of information unless it displays a valid OMB control number
POWER OF ATTORNEY TO PROSECUTE APPLICATIONS BEFORE THE USPTO
I hereby revoke all previous powers of attorney given in the application identified in the attached
statement under 37 CFR 3.73(c).
I hereby appoint:
Practitioners associated with Customer Number:
OR
Practitioner(s) named below (if more than ten patent practitioners are to be named, then a customer number must be used):
Registration
Registration
Name
Name
Number
Number
As attorney(s) or agent(s) to represent the undersigned before the United States Patent and Trademark Office (USPTO) in connection with
any and all patent applications assigned only to the undersigned according to the USPTO assignment records or assignment documents
attached to this form in accordance with 37 CFR 3.73(c).
Please change the correspondence address for the application identified in the attached statement
under 37 CFR 3.73(c) to:
The address associated with Customer Number:
OR
Firm or individual name
Address
City
State
Zip
Country
Telephone
Email
Assignee name and address:
A copy of this form, together with a statement under 37 CFR 3.73(c) (Form PTO/AIA/96 or equivalent) is required to be
filed in each application in which this form is used. The statement under 37 CFR 3.73(c) may be completed by one of the
practitioners appointed in this form, and must identify the application in which this Power of Attorney is to be filed.
SIGNATURE of Assignee of Record
The individual whose signature and title is supplied below is authorized to act on behalf of the assignee.
Signature
Date
Name
Telephone
Title
This collection of information is required by 37 CFR 1.31, 1.32, and 1.33. The information is required to obtain or retain a benefit by the public, which is to update
(and by the USPTO to process) the file of a patent or reexamination proceeding. Confidentiality is governed by 35 U.S.C. 122 and 37 CFR 1.11 and 1.14. This
collection is estimated to take 18 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.

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