PTO/AIA/81 (07-12)
Approved for use through 01/31/2018. OMB 0651-0035
U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
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Application Number

POWER OF ATTORNEY TO ONE OR
MORE OF THE JOINT INVENTORSAND CHANGE OF
CORRESPONDENCE ADDRESSFiling DateFirst Named Inventor
Art Unit
Examiner NameTitle

NOTE: This form may be filed by pro se inventors (i.e., prosecuting the application without a registered patentpractitioner) who are identified as the Applicant in the above-identified application. For a Power of Attorney to one
or more registered patent practitioners, see form PTO/AIA/82.
I hereby revoke all previous powers of attorney given in the above-identified application.
I hereby appoint the following joint inventor(s) to prosecute the application identified above, andto transact all business in the United States Patent and Trademark Office connected therewith:

Please recognize or change the correspondence address for the above-identified application to:
The address associated with Customer Number. (if applicable):-To Request A Customer Number see form PTO/SB/124

OR
Individual Name
AddressCityState

ZipCountryTelephone

EmailI am the Inventor.
SIGNATURE of Inventor

Signature

DateName

Telephone

NOTE: Signatures of all the inventors are required. Submit multiple forms if more than one signature is required, see below*. See 37 CFR 1.4 for signature

requirements and certifications.
*Total offorms are submitted.
JRF

This collection of information is required by 37 CFR 1.31, 1.32 and 1.33. The information is required to obtain or retain a benefit by the public which is to file (and by theUSPTO to process) an application. Confidentiality is governed by 35 U.S.C. 122 and 37 CFR 1.11 and 1.14. This collection is estimated to take 15 minutes to complete,including gathering, preparing, and submitting the completed application form to the USPTO. Time will vary depending upon the individual case. Any comments on
the amount of time you require to complete this form and/or suggestions for reducing this burden, should be sent to the Chief Information Officer, U.S. Patent andTrademark Office, U.S. Department of Commerce, P.O. Box 1450, Alexandria, VA 22313-1450. DO NOT SEND FEES OR COMPLETED FORMS TO THISADDRESS. SEND TO: Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313-1450.

If you need assistance in completing the form, call 1-800-PTO-9199 and select option 2.

Privacy Act Statement
The Privacy Act of 1974 (P.L. 93-579) requires that you be given certain information in connection
with your submission of the attached form related to a patent application or patent. Accordingly,
pursuant to the requirements of the Act, please be advised that: (1) the general authority for thecollection of this information is 35 U.S.C. 2(b)(2); (2) furnishing of the information solicited is voluntary;and (3) the principal purpose for which the information is used by the U.S. Patent and Trademark
Office is to process and/or examine your submission related to a patent application or patent. If you do
not furnish the requested information, the U.S. Patent and Trademark Office may not be able toprocess and/or examine your submission, which may result in termination of proceedings orabandonment of the application or expiration of the patent.
The information provided by you in this form will be subject to the following routine uses:
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The information on this form will be treated confidentially to the extent allowed under theFreedom of Information Act (5 U.S.C. 552) and the Privacy Act (5 U.S.C 552a). Records fromthis system of records may be disclosed to the Department of Justice to determine whether
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CFR 1.14, as a routine use, to the public if the record was filed in an application whichbecame abandoned or in which the proceedings were terminated and which application isreferenced by either a published application, an application open to public inspection or anissued patent.
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