Form Pto/sb/2048a - Complaint Regarding Invention Promoter

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Approved for use through 3/31/2019. OMB 0651-0044
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.
Instructions: Read the reverse side of this form before completing and submitting the form. Complete as much of the
form as possible and return it to the U.S. Patent and Trademark Office, Mail Stop 24, Commissioner for Patents,
P.O. Box 1450, Alexandria, VA 22313-1450 or fax to (571) 273-0170. Please type or write clearly.
Name of the Invention Promotion Company:
Invention Promoter’s Address:
Zip Code
Complainant’s Name:
Complainant’s Address:
Zip Code
Customer’s Name:
Please be as specific as possible within the space provided
Name of mass media invention promoter advertised in: (i.e., TV, Radio, Newspaper, Magazine, Other)
Invention promotion services offered to be performed:
Explanation of complaint between customer and invention promoter:
Signed: ________________________________________ Date: ___________________
Burden Hour Statement: This collection of information is provided for by 35 U.S.C. § 297(d). The information regarding invention promoters will
be released to the public. This form is estimated to take 15 minutes to complete. This time will vary depending upon the needs of the individual
case. Any comments on the amount of time you are required to complete this form should be sent to the U.S. Patent and Trademark Office, Mail
Stop Chief Information Officer, P.O. Box 1450,Alexandria, VA 22313-1450. DO NOT SEND FEES OR COMPLETED FORMS TO THIS ADDRESS.


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