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Re-Examination Request
RE-EXAMINATION REQUEST
IN THE UNITED STATES PATENT AND TRADEMARK OFFICE
In re patent of: [Name]
Patent No.: [Patent number]
Issued on: [Date issued]
For: [Item]
REQUEST FOR RE-EXAMINATION
To the Honorable Commissioner of Patents and Trademarks:
This is to request re-examination of the United States patent, number
[atent number], which was issued on [Date issued] to [Name] and which is still in force.
List here any claims [Explanation of their Relevancy] for which this re-examination is requested. In addition, set forth any new questions regarding the patentability of the item: [Questions regarding patentability]
Signature: Date:
Certificate of Service
I hereby certify that a true and correct copy of the above Request for Re-examination was mailed on [Date] by first-class mail, postage paid, to:
[Name]
[Complete Mailing Address]
Signature: Date: