Form Pto/sb/16 2007 - Provisional Application For Patent Cover Sheet Page 2
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PROVISIONAL APPLICATION COVER SHEET
Page 2 of 2
PTO/SB/16 (10-07)
Approved for use through 06/30/2010. OMB 0651-0032
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.
The invention was made by an agency of the United States Government or under a contract with an agency of the United States Government.
No.
Yes, the name of the U.S. Government agency and the Government contract number are: ___________________________________
___________________________________________________________________________________________________________
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_________________________________
TYPED or PRINTED NAME ___________________________________________________
REGISTRATION NO. ___________________
(if appropriate)
TELEPHONE ______________________________________________
Docket Number: __________________________________
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