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Power Of Attorney Or Address Change

IN THE UNITED STATES PATENT AND TRADEMARK OFFICE

In re patent of: ___________________ (Name)

Patent No.: ______________________

Issued on: _______________________ (Date)

For: ____________________________ (Item)

To the Honorable Commissioner of Patents and Trademarks:

Please make the following change to the above patent which was granted to ____________ (Name of Inventor) on the date noted above: (Check the Item Which Applies and Fill in the Appropriate Information)

(____) Change the address of the attorney(s) of record to:

(____) Change the correspondence address of the patent owner to:

(____) Add a power of attorney to, and address any future correspondence to, the following person whom I appoint to handle all business pertaining to the above patent in the Patent and Trademark Office:

(____) I hereby revoke and remove all previous powers of attorney and enter a power of attorney in favor of the following person whom I hereby appoint to transact all business pertaining to the above patent in the Patent and Trademark Office. All future correspondence should be addressed to this person as well:

The person whose signature appears below is certified to have the authority to make these requested changes in the patent.

Signature: __________________

(After the Signature, Also State Whether the Person Signing is the Patent Owner or the Owners Attorney/Agent)

Date: ______________.