Form Pto/aia/63 - Terminal Disclaimer To Accompany Petition Under 37 Cfr 1.137 In A Design Application Filed On Or After September 16, 2012

Download a blank fillable Form Pto/aia/63 - Terminal Disclaimer To Accompany Petition Under 37 Cfr 1.137 In A Design Application Filed On Or After September 16, 2012 in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form Pto/aia/63 - Terminal Disclaimer To Accompany Petition Under 37 Cfr 1.137 In A Design Application Filed On Or After September 16, 2012 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

PTO/AIA/63 (07-16)

Approved for use through 7/31/2016. 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.

Docket Number (Optional)

TERMINAL DISCLAIMER TO ACCOMPANY PETITION

UNDER 37 CFR 1.137 IN A DESIGN APPLICATION

FILED ON OR AFTER SEPTEMBER 16, 2012

Applicant:

First named inventor:

Application No.:

Filed:

For:

The applicant, _____________________________________________, owner of __________ percent interest in the instant design

application, hereby disclaims a terminal part of the statutory term of any patent granted on the instant design application equivalent to the

period of abandonment of the instant design application. This disclaimer also applies to any patent granted on a continuing design

application that contains a specific reference under 35 U.S.C. 120, 121, 365(c), or 386(c) to the instant design application. This disclaimer

is binding upon the grantee, and its successors or assigns.

Check either box 1 or 2 below, if appropriate.

I hereby acknowledge that any willful false statements made are punishable under 18 U.S.C. 1001 by fine or imprisonment of not more

than five (5) years, or both.

The undersigned is the applicant. If the applicant is an assignee, the undersigned is authorized to act on behalf of the assignee.

The undersigned is an attorney or agent of record. Reg. No. _______________

__________________________________________________________

__________________________________

Signature

Date

__________________________________________________________

__________________________________

Typed or printed name

Telephone number

_______________________________________________________________________________________________

Title

The terminal disclaimer fee under 37 CFR 1.20(d) is included.

WARNING: Information on this form may become public. Credit card information should not

be included on this form. Provide credit card information and authorization on PTO-2038.

This collection of information is required by 37 CFR 1.137. The information is required to obtain or retain a benefit by the public, i.e., to prosecute a patent

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 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.