Verified Statement (Petition to Make Special)

Fill out the PTO/SB/15A form. Your entries will be injected into the official PDF.

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Form Inputs & Parameters

0 of 10 filled

General

Application Number or Control Number if applicable

Patent Number if applicable

First Named Inventor

Title of Invention

Signature

Name

Date

Telephone

Registration No

There Is More Than One Inventor And I Am One Of The Inventors Who Are Jointly Identified As The Applicant

There is more than one inventor and I am one of the inventors who are jointly identified as the applicant. The required additional certification form(s) signed by the other joint inventor(s) are included with this formSelect / Yes

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USPTO Official Form Sheet (PTO-SB-15A)

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