| Ernest
H. McCoy PATENT ATTORNEY PATENT LAWYER INTELLECTUAL PROPERTY LAWYER IP LAWYER IP ATTORNEY |
| APPLICANT INFORMATION FORM |
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Name
of client:
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___________________________________ | |
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Home
address of client:
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___________________________________ ___________________________________ |
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Telephone
numbers:
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Home____________________________ | Fax_________________________ |
| Bus______________________________ | Fax_________________________ | |
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Inventor's
names:
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1)___________________________________ 2)___________________________________ 3)___________________________________ |
If there are more than three inventors list on another page. |
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Inventor(s)
home address(es):
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1)___________________________________ ____________________________________ 2)___________________________________ ____________________________________ 3)___________________________________ ____________________________________ |
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Inventor(s) mailing address(es):
If different from above both are required by the Patent Office. |
1)___________________________________ ____________________________________ 2)___________________________________ ____________________________________ 3)___________________________________ ____________________________________ |
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Inventor's nationality: (required by USPTO in inventor's declaration) |
1)___________________________________ 2)___________________________________ 3)___________________________________ |
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| Date of first written description of the invention:____________________________________________ | ||
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Date of first drawings:____________________________________________
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Date of first prototype:____________________________________________
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Date of first offer
for sale:_________________________________________
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Date of first public
use:___________________________________________
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| Date of first disclosure of the invention in a printed publication of general circulation: ________________ |
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Check box for warranty
acceptance and read attorney-client contract [__]
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| INVENTION DISCLOSURE |
| Was prior art search disclosure sent to Bruce & McCoy? ____________________________________ |
| If not, please send prototype pictures, engineering drawings, or sketches, and a written description of the invention, disclosing sufficient detail to enable the draftsman to create the patent drawings and for the attorney to describe the invention in words for the application. |
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