Fillable Assignment Of Application Form printable pdf download

Sample Form (former PTO/SB/15) (08-03)

Docket Number (Optional)

ASSIGNMENT OF APPLICATION

Whereas, I/We, ___________________________________of ____________________________, hereafter

referred to as applicant, have invented certain new and useful improvements in _______________________

_______________________________________________________________________________________

for which an application for a United States Patent was filed on ________________________________

Application Number ________________________.

for which an application for a United States Patent was executed on ________________________, and

Whereas, __________________________of ________________________________________here referred

to “assignee” whose mailing address is ______________________________________________________is

desirous of acquiring the entire right, title and interest in the same;

one

Now, therefore, in consideration of the sum of __________dollars

($ _________), the receipt whereof is

acknowledge, and other good and valuable consideration, I/We, the applicant(s), by these presents do sell, assign

and transfer unto said assignee the full and exclusive right to the said invention in the United States and the entire

rights, title and interest in and to any and all Patents which may be granted therefore in the United States. I/We

hereby authorize and request the Director of the U.S. Patent and Trademark Office to issue said United States

Patent to said assignee, of the entire right, title, and interest in and to the same, for his sole use and behoof; and

for the use and behoof of his legal representatives, to the full end of the term for which said Patent may be

granted, as fully and entirely as the same would have been held by me had this assignment and sale not been

made.

Executed this ______________________day of ___________________________, 20 _________________.

at ____________________________________________________________________________________.

___________________________________________

Signature

State of _________________)

___________________________________________

SS:

Printed Name/Registration No., if applicable

County of _______________)

Before me personally appeared said ___________________________________________________

and acknowledged the foregoing instrument to be his free act and deed this ___________________

Notary Public, State of Texas

day of __________________, 20 _________.

Seal

My Commission Expires:

Note: Signatures of all the inventors or assignees of record of the entire interest or their representative(s) are required. Submit multiple forms if

more than one signature is required, See below*.

Total of ___________________forms are submitted.

This form offers a sample or suggested format for an assignment document. This sample form is not an OMB officially approved form.

Assignment Of Application Form