Form Pto/aia/83 - Request For Withdrawal As Attorney Or Agent And Change Of Correspondence Address Note: A Request For Withdrawal As Attorney Or Agent May Alternatively Be Filed As A Web-Based Epetition

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Doc Code: PET.POA.WDRW

Document Description: Petition to withdraw attorney or agent (SB83)

PTO/AIA/83 (04-13)

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 persons are required to respond to a collection of information unless it displays a valid OMB control number.

Application Number

REQUEST FOR WITHDRAWAL

Filing Date

AS ATTORNEY OR AGENT AND

First Named Inventor

CHANGE OF

Art Unit

CORRESPONDENCE ADDRESS

Examiner Name

Practitioner Docket

Number

To:

Commissioner for Patents

P.O. Box 1450

Alexandria, VA 22313-1450

Please withdraw me as attorney or agent for the above-identified patent application, and

all the practitioners of record;

the practitioners (with registration numbers) of record listed on the attached paper(s); or

the practitioners of record associated with Customer Number: _______________________________

NOTE: The immediately preceding box should only be marked when the practitioners were appointed using the listed

Customer Number.

The reason(s) for this request are those described in 37 CFR:

11.116(a)(1)

11.116(a)(2)

11.116(a)(3)

11.116(b)(1)

11.116(b)(2)

11.116(b)(3)

11.116(b)(4)

11.116(b)(5)

11.116(b)(6)

11. 116(b)(7) Please explain below:

Certifications

Check each box below that is factually correct. WARNING: If a box is left unchecked, the request will likely not be

approved.

I/We have given reasonable notice to the client, prior to the expiration of the response period, that the

practitioner(s)

intend to withdraw from employment.

I/We have delivered to the client or a duly authorized representative of the client all papers and property (including

funds) to which the client is entitled.

I/We have notified the client of any responses that may be due and the time frame within which the client must

respond.

Please provide an explanation, if necessary:

[Page 1 of 2]

This collection of information is required by 37 CFR 1.36. 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 15 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.