USPTO Power of Attorney Revocation Form

The USPTO Power of Attorney Revocation is a form that is used to revoke a previously made power of attorney for the use of a U.S Patent and Trademark. If there is a need, you can allow another person to fill the place of the previous agent.

Extracted Text for Proper Search

PTO/SB/81 (	11-08)	Approved for use through 11/30/2011. 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 re\�spond to a collection of information unless it displays	 a valid OMB control number.	
Application Number
Filing Date
First Named Inventor
Title
Art Unit
Examiner Name	
POWER OF ATTORNEYOR
REVOCATION OF POWER OF ATTORNEY WITH A NEW POWER OF ATTORNEY AND
CHANGE OF CORRESPONDENCE ADDRESS	
Attorney Docket Number	
This  collection  of information  is required  by 37  CFR  1.31,  1.32 and 1.33.  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  3 minutes 	to  complete,
including  gathering,  preparing,  and submitting  the completed  application  form to the  USPTO.   Time  will vary  depend	ing 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 s\�elect option 2.	
I hereby revoke all previous powers of attorney given in the above-ident\�ified application.	
I hereby appoint Practitioner(s) associated with the following Custome\�r
Number as my/our attorney(s) or agent(s) to prosecute the applicatio\�n
identified above, and to transact all business in the United States Pate\�nt
and Trademark Office connected therewith:	
OR	I hereby appoint Practitioner(s) named below as my/our attorney(s) o\�r agent(s) to prosecute the application identified above, and
to transact all business in the United States Patent and Trademark Offic\�e connected therewith:	
Practitioner(s) Name	Registration Number	
Please recognize or change the correspondence address for the above-iden\�tified application to:	
OR	
The address associated with Customer Number:
Firm orIndividual Name	
Address
City	State	Zip	
Country
Telephone	Email	
I am the:	
Applicant/Inventor.
Assignee of record of the entire interest. See 37 CFR 3.71.
Statement under 37 CFR 3.73(b) (Form PTO/SB/96) submitted herewith o\�r filed on  ______________________________.	
SIGNATURE of Applicant or Assignee of Record	
Signature	Date	
Name	Telephone	
Title and Company
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 onesignature is re	quired	, see below*.	
*Total of ____________ forms are submitted.
OR	
A Power of Attorney is submitted herewith.
The address associated with the above-mentioned Customer Number.	
OR
OR

Privacy Act Statement	
The Privacy  Act of 1974  (P.L. 93-579)  requires  that you be given  certain  information  in connection
with your submission of the attached form related to a patent applicatio\�n or patent. Accordingly,
pursuant  to the  requirements  of the  Act,  please  be advised  that: (1) the  general  authority  for the
collection  of this  information  is 35  U.S.C.  2(b)(2);  (2) furnishing  of the  information  solicited is voluntary;
and (3) the principal purpose for which the information is used by the\� U.S. Patent and Trademark
Office  is to  process  and/or examine  your submission  related to a patent  application  or patent.  If you  do
not furnish the requested information, the U.S. Patent and Trademark Off\�ice may not be able to
process  and/or examine  your submission,  which may result  in termination  of proceedings  or
abandonment of the application or expiration of the patent.
The information provided by you in this form will be subject to the foll\�owing routine uses:	
1.	The  information  on this  form  will be treated  confidentially  to the  extent  allowed  under the
Freedom  of Information  Act (5 U.S.C.  552) and the Privacy  Act (5 U.S.C  552a).  Records  from
this system of records may be disclosed to the Department of Justice to \�determine whether
disclosure of these records is required by the Freedom of Information Ac\�t.	
2.	A  record  from this system  of records  may be disclosed,  as a routine  use, in the  course  of
presenting  evidence to a court,  magistrate,  or administrative  tribunal, including  disclosures  to
opposing counsel in the course of settlement negotiations.	
3.	A  record  in this  system  of records  may be disclosed,  as a routine  use, to a Member  of
Congress  submitting  a request  involving  an individual,  to whom  the record  pertains,  when the
individual  has requested  assistance  from the Member  with respect  to the  subject  matter of the
record.	
4.	A  record  in this  system  of records  may be disclosed,  as a routine  use, to a contractor  of the
Agency having need for the information in order to perform a contract. R\�ecipients of
information  shall be required  to comply  with the requirements  of the  Privacy  Act of 1974,  as
amended, pursuant to 5 U.S.C. 552a(m).	
5.	A  record  related  to an  International  Application filed under  the Patent  Cooperation  Treaty in
this  system  of records  may be disclosed,  as a routine  use, to the  International  Bureau of the
World Intellectual Property Organization, pursuant to the Patent Coopera\�tion Treaty.	
6.	A  record  in this  system  of records  may be disclosed,  as a routine  use, to another  federal
agency  for purposes  of National  Security review (35 U.S.C.  181) and for review  pursuant  to
the Atomic Energy Act (42 U.S.C. 218(c)).	
7.	A  record  from this system  of records  may be disclosed,  as a routine  use, to the  Administrator,
General  Services,  or his/her  designee,  during an inspection  of records  conducted  by GSA  as
part of that agency's responsibility to recommend improvements in record\�s management
practices  and programs,  under authority  of 44  U.S.C.  2904 and 2906.  Such disclosure  shall
be made in accordance with the GSA regulations governing inspection of r\�ecords for this
purpose,  and any other  relevant  (i.e., GSA  or Commerce)  directive. Such disclosure  shall not
be used to make determinations about individuals.	
8.	A  record  from this system  of records  may be disclosed,  as a routine  use, to the  public  after
either publication of the application pursuant to 35 U.S.C. 122(b) or \�issuance of a patent
pursuant  to 35  U.S.C.  151. Further,  a record  may be disclosed,  subject to the  limitations  of 37
CFR 1.14, as a routine use, to the public if the record was filed in an \�application which
became  abandoned  or in which  the proceedings  were terminated  and which  application  is
referenced  by either  a published  application,  an application  open to public  inspection  or an
issued patent.	
9.	A  record  from this system  of records  may be disclosed,  as a routine  use, to a Federal,  State,
or local law enforcement agency, if the USPTO becomes aware of a violati\�on or potential
violation of law or regulation.