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Declaration And Power Of Attorney For Patent Application (Multiple Inventors) (Japanese) PTO-SB-106 - Official Federal Forms
| Declaration And Power Of Attorney For Patent Application (Multiple Inventors) (Japanese) Form. This is a national form and can be used in Patent US Patent Office . |
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PTO/SB/106(5-00) Approved for use through 6/30/2010. OMB 0651-0032 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 Declaration and Power of Attorney for Patent Application Japanese Language Declaration As a below named inventor, I hereby declare that: My residence, post office address and citizenship are as stated next to my name. I believe I am the original, first and sole inventor (if only one name is listed below) or an original, first and joint inventor (if plural names are listed below) of the subject matter which is claimed and for which a patent is sought on the invention entitled the specification of which is attached hereto unless the following box is checked: PCT was filed on as United States Application Number or PCT International Application Number and was amended on (if applicable). I hereby state that I have reviewed and understand the contents of the above identified specification, including the claims, as amended by any amendment referred to above. Burden Hour Statement: This form is estimated to take 0.4 hours to complete. Time will vary depending upon the need of the individual case. Any comments on the amount of time you are required to complete this form should be sent to Chief Information Officer, U.S. Patent and Trademark Office, Washington, DC 20231. DO NOT SEND FEES OR COMPLETED FORMS TO THIS ADDRESS. SEND TO: Commissioner of Patents and Trademarks, Washington, DC 20231. Page 1 of 5 American LegalNet, Inc. www.FormsWorkflow.com PTO/SB/106(5-00) Approved for use through 6/30/2010. OMB 0651-0032 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 I acknowledge the duty to disclose information which is material to patentability as defined in Title 37, Code of Federal Regulations, Section 1.56. Japanese Language Declaration () a PCT a -(d)(b) PCT I hereby claim foreign priority under Title 35, United States Code, Section 119(a)-(d) or 365(b) of any foreign application(s) for patent or inventor's certificate, or 365(a) of any PCT International application which designated at least one country other than the United States listed below and have also identified below, by checking the box, any foreign application for patent or inventor's certificate, or PCT International application having a filing date before that of the application for which priority is claimed Prior Foreign Application(s) Priority Not Claimed (Number) (Country) (Day/Month/Year Filed) (Number) (Country) (Day/Month/Year Filed) I hereby claim the benefit under Title 35. United States Code, Section 119(e) of any United States provisional application(s) listed below. 35 () (Application No.) (Filing Date) (Application No.) (Filing Date) () 1 I hereby claim the benefit under Title 35, United States Code, Section 120 of any United States application(s), or 365(c) of any PCT International application designating the United States, listed below and, insofar as the subject matter of each of the claims of this application is not disclosed in the prior United States or PCT International application in the manner provided by the first paragraph of Title 35, United States Code Section 112, I acknowledge the duty to disclose information which is material to patentability as defined in Title 37, Code of Federal Regulations, Section 1.56 which became available between the filing date of the prior application and the national or PCT International filing date of application. (Application No.) (Filing Date) (Status: Patented, Pending, Abandoned) Burden Hour Statement: This form is estimated to take 0.4 hours to complete. Time will vary depending upon the need of the individual case. Any comments on the amount of time you are required to complete this form should be sent to Chief Information Officer, U.S. Patent and Trademark Office, Washington, DC 20231. DO NOT SEND FEES OR COMPLETED FORMS TO THIS ADDRESS. SEND TO: Commissioner of Patents and Trademarks, Washington, DC 20231. Page 2 of 5 American LegalNet, Inc. www.FormsWorkflow.com PTO/SB/106(5-00) Approved for use through 6/30/2010. OMB 0651-0032 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 No.) (Filing Date) (Status: Patented, Pending, Abandoned) I hereby declare that all statements made herein of my own knowledge are true and that all statements made on information and belief are believed to be true; and further that these statements were made with the knowledge that willful false statements and the like so made are punishable by fine or imprisonment, or both, under Section 1001 of Title 18 of the United States Code and that such willful false statements may jeopardize the validity of the application or any patent issued thereon. Japanese Language Declaration () POWER OF ATTORNEY: As a named inventor, I hereby appoint the following attorney(s) and/or agent(s) to prosecute this application and transact all business in the Patent and Trademark Office connected therewith (list name and registration number). Please recognize or change the correspondence address for the above-identified application to the address associated with the above-mentioned Customer Number: Burden Hour Statement: This form is estimated to take 0.4 hours to complete. Time will vary depending upon the need of the individual case. Any comments on the amount of time you are required to complete this form should be sent to Chief Information Officer, U.S. Patent and Trademark Office, Washington, DC 20231. DO NOT SEND FEES OR COMPLETED FORMS TO THIS ADDRESS. SEND TO: Commissioner of Patents and Trademarks, Washington, DC 20231. Page 3 of 5 American LegalNet, Inc. www.FormsWorkflow.com PTO/SB/106(5-00) Approved for use through 6/30/2010. OMB 0651-0032 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 Full name of sole or first inventor Inventor's signature Residence Citizenship Post Office Address Date Full name of second joint inventor, if a
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