The Form PTO-158 serves a critical gateway for professionals seeking to practice before the United States Patent and Trademark Office (USPTO). With its detailed requirement for personal, educational, and professional information, this form is designed to scrutinize applicants to ensure they meet the stringent eligibility criteria set forth by the USPTO. The form mandates the disclosure of comprehensive background information, including any past charges or disciplinary actions across various spectrums, which underscores the importance of transparency and candor in the process. Additionally, it includes provisions for those with different citizenship statuses, demonstrating inclusivity in eligibility for practice. The collection of this information, as mandated by relevant sections of the Code of Federal Regulations (CFR) and supported by the Paperwork Reduction Act of 1995, is a testament to the rigorous standards upheld by the USPTO to maintain integrity within the patent practice field. Notably, the form also outlines the application and examination fees, shedding light on the financial commitment required from applicants. This level of detail highlights the comprehensive nature of the screening process, intending to admit only qualified individuals to practice before the USPTO while maintaining a high standard of service to the inventors and businesses relying on the patent system.
| Question | Answer |
|---|---|
| Form Name | Form Pto 158 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | OED, CFR, 16th, delinquencies |
|
OMB No. 0651‐0012 Approval Expires 09/30/2014 |
FORM PTO‐158 (Rev. Feb. 21, 2013) |
United States Patent and Trademark Office |
APPLICATION FOR REGISTRATION TO PRACTICE
BEFORE THE UNITED STATES PATENT AND TRADEMARK OFFICE
Under the Paperwork Reduction Act of 1995, no person is required to respond to a collection of information unless it displays a valid OMB control number. This collection of information is required by 37 CFR §§ 11.5 through 11.11. This information is used by the public to register to practice before the United States Patent and Trademark Office (USPTO) and by the USPTO to determine the eligibility of the applicant to register to practice before the USPTO. The information on this form will be treated confidentially to the extent allowed under the Privacy Act and the Freedom of Information Act (FOIA). Response to this information collection is voluntary; however, if you do not provide the requested information, the USPTO may not admit you to the registration examination or register you to practice before the USPTO. This form is estimated to take 30 minutes to complete, including gathering, preparing, and submitting the information on the application to the USPTO. Any comments on the amount of time required to complete this form and/or suggestions for reducing this burden, should be sent to the Chief Information Officer, United States Patent and Trademark Office. DO NOT SEND FEES OR COMPLETED FORMS TO THIS ADDRESS.
SEND TO: Mail Stop OED, United States Patent and Trademark Office, P.O. Box 1450, Alexandria, VA 22313‐1450
THIS SPACE FOR UNITED STATES PATENT
AND TRADEMARK OFFICE USE ONLY
First Name |
Middle Name |
Last Name |
1a. Legal Name
1b. Name shown on valid Government ID
Employer, corporation, law firm, U.S. Government agency. Indicate if student or unemployed.
1c. Address (street, bldg., suite, etc.)
1d. City |
1e. State |
1f. Zip code |
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Reasonable
Accommodation
Request Attached
1g. Phone Number (daytime)
1h. E‐mail (primary)
1i. E‐mail (secondary)
2. Citizenship (country)
FOR ALIENS 5. Visa Classification
ONLY
3. |
Date of Birth (month, day, year) |
4. Place of Birth (City, State, Country) |
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6. Permanent Resident of the United States |
7. Alien Registration Number |
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☐YES Attach copy of both sides of
☐ NO
You are required to update the foregoing information promptly upon any change. Select and check all the following that apply. Applicants should carefully review the General Requirements Bulletin for detailed instructions on completing this application.
8a. Application Fee: (Please refer to the General Requirements Bulletin and 37 CFR § 11.7)
☐Enclosed is the non‐refundable $40.00 application fee set forth in 37 CFR § 1.21(a)(1)(i).
OR
☐Enclosed is the $1,600.00 fee set forth in 37 CFR § 1.21(a)(10).
8b. Registration Examination Fee:
☐I will utilize a commercial test administration service. Enclosed in the Government registration examination fee of $200 for test administration by a commercial entity. 37 CFR § 1.21(a)(1)(ii)(A)
☐I request USPTO test administration. Enclosed is the Government registration examination fee of $450.00 for test administration by USPTO. 37 CFR § 1.21(a)(1)(ii)(B)
9.Waiver of Examination: I am a former USPTO employee and satisfy the requirements of:
☐37 CFR § 11.7(d)(1). Enclosed is the applicable fee under either 37 CFR § 1.21(a)(1)(i) OR 37 CFR § 1.21(a)(10)
☐37 CFR § 11.7(d)(2). Enclosed is the applicable fee under either 37 CFR § 1.21(a)(1)(i) OR 37 CFR § 1.21(a)(10)
☐37 CFR § 11.7(d)(3). Enclosed is the applicable fee under either 37 CFR § 1.21(a)(1)(i) OR 37 CFR § 1.21(a)(10)
10.☐ Passed Examination: I passed an examination on _____________________. Enclosed is the required registration fee of $100.00 (37 CFR § 1.21(a)(2)) and a completed data sheet.
11.☐ Reinstatement: I am applying for reinstatement, or as a former government employee, for a change from inactive to active status. Enclosed is my required fee under 37 CFR § 1.21.
12.☐ I previously applied for admission to the registration examination or requested the Office of Enrollment and Discipline to evaluate my scientific and technical qualifications.
Date of Previous Application: ____________________ Name on Application, if different: _______________________________
13.☐ I was previously registered to practice in patent cases before the United States Patent and Trademark Office as an attorney
or agent. If “YES”, my Registration No. is _______________________________
14.☐ BAR MEMBERSHIP. I am a member in good standing of the bar of the highest court of a State or Territory of the United States. A list of all said courts and corresponding bar membership numbers(s) follows:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
FORM PTO‐158 (Rev. Feb. 21, 2013) |
Page 2 |
BACKGROUND INFORMATION: Candor and truthfulness are significant elements of fitness relevant to practice before the United States Patent and Trademark Office. You should, therefore, provide the Office of Enrollment and Discipline with all available information, however unfavorable, even if its relevance is in doubt, with regard to the questions asked below. For each question answered “YES,” provide a detailed statement setting forth all relevant facts and dates along with verified copies of relevant documents. Your responses must be updated, as necessary, prior to your registration. Any documents, evidence or proofs previously filed in a prior application need not be resubmitted unless your response to a question must be changed. Failure to disclose the requested information may result in denial of registration
or in disciplinary proceedings under 37 CFR § 10.22, should you become registered.
☐YES ☐ NO
☐YES ☐ NO
☐YES ☐ NO
☐YES ☐ NO
☐YES ☐ NO
☐YES ☐ NO
☐YES ☐ NO
☐YES ☐ NO
15.Have any charges ever been preferred against you in connection with your practice before any Federal or State court, or municipal bureau, commission, office or agency of any kind or character?
16.Have you ever been arrested, charged or held by Federal, State or other law enforcement authorities for any
violation of any Federal or State law, or any country or municipal law, regulation or ordinance? (Do not include any misdemeanor before your 16th birthday or traffic violations for which the fine was $100 or less.)
17.Have you ever been disciplined, reprimanded, suspended, expelled or asked to resign or withdraw from any educational institution, or have you resigned or withdrawn from any such institution in time to avoid a request to resign or in time to avoid discipline, reprimand, suspension, or expulsion for conduct involving dishonesty, fraud, misrepresentation, or deceit?
18.Have you ever been disciplined, reprimanded, or suspended in any job for conduct involving dishonesty, fraud, misrepresentation, deceit, or for any violation of Federal or State laws or regulations?
19.Have you ever been fired or discharged from any job, or have you been asked to resign or quit for conduct involving dishonesty, fraud, misrepresentation, deceit, or any violation of Federal or State laws or regulations?
20.Have you ever resigned or quit a job when you were under investigation or inquiry for conduct which could have been considered as involving dishonesty, fraud, misrepresentation, deceit, or violation of Federal or State laws or regulations, or after receiving notice or been advised of possible investigation, inquiry, or disciplinary action for such conduct?
21.Have you ever been discharged from military service under conditions “other than honorable,” or by reason of the sentence of a Court Martial or being dropped from the rolls?
22.Are you delinquent on any State or Federal debt? (Include delinquencies arising from Federal or State taxes, loans, overpayment of benefits, and other debts to the U.S. Government and defaults on Federally guaranteed or insured loans such as student and home mortgage loans.)
23.EDUCATION: List all degrees conferred in the blocks below. Attach to this application any required documentation to complete your application for registration. Refer to the General Requirements Bulletin. If you applied previously for an exam, please see the General Requirements Bulletin section titled “REAPPLYING TO TAKE THE EXAMINATION” for what you must submit.
Degree Received as |
College |
Date Received |
Major Subject as indicated |
indicated on Transcript |
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Upon the basis of the foregoing information and any attached documents, I hereby apply for registration to practice in patent matters before the United States Patent and Trademark Office. I certify that each and every statement or representation in this application is true and correct.
24. Signature of Applicant |
Date |
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Mail completed application to:
Mail Stop OED, United States Patent and Trademark Office, P. O. Box 1450, Alexandria, VA 22313‐1450