Form Pto/aia/06 - Reissue Application Declaration By The Assignee Page 2

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Doc Code:
PTO/AIA/06 (02-17)
Approved for use through 01/31/2020. 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 APPLICATION DECLARATION BY THE ASSIGNEE
Docket Number (Optional)
At least one error upon which reissue is based is described below. If the reissue is a broadening
reissue, a claim that the application seeks to broaden must be identified and the box below must be checked:
[Attach additional sheets, if needed.]
The application for the original patent was filed under 37 CFR 1.46 by the assignee of the entire interest.
I hereby appoint:
Practitioners associated with Customer Number:
OR
Practitioner(s) named below:
Name
Registration Number
as my/our attorney(s) or agent(s) to prosecute the application identified above, and to transact all business in the United
States Patent and Trademark Office connected therewith.
Correspondence Address: Direct all communications about the application to:
The address associated with Customer Number:
OR
Firm or
Individual
Name
Address
City
Zip
State
Country
Telephone
Email
WARNING:
Petitioner/applicant is cautioned to avoid submitting personal information in documents filed in a patent application that may
contribute to identity theft. Personal information such as social security numbers, bank account numbers, or credit card
numbers (other than a check or credit card authorization form PTO-2038 submitted for payment purposes) is never required by
the USPTO to support a petition or an application. If this type of personal information is included in documents submitted to
the USPTO, petitioners/applicants should consider redacting such personal information from the documents before submitting
them to the USPTO. Petitioner/applicant is advised that the record of a patent application is available to the public after
publication of the application (unless a non-publication request in compliance with 37 CFR 1.213(a) is made in the application)
or issuance of a patent. Furthermore, the record from an abandoned application may also be available to the public if the
application is referenced in a published application or an issued patent (see 37 CFR 1.14).
Checks and credit card
authorization forms PTO-2038 submitted for payment purposes are not retained in the application file and therefore are not
publicly available.
Signature
Date (Optional)
Legal name of person signing
Address of Assignee
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