Form PTO/SB/16 at a glance
What it is: The Provisional Application for Patent Cover Sheet is a request for filing a provisional application for patent under 37 CFR 1.53(c).
Where and when to file: If filing this completed form by mail, send to: Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313-1450.
Use only for filing a provisional application for patent.
A filled-in Form PTO/SB/16 example: two inventors file a provisional application as a small entity
How to fill out Form PTO/SB/16, box by box
Priority Mail Express Label No.
Enter the Priority Mail Express Label No.
Inventor(s)
Under INVENTOR(S), enter Given Name (first and middle [if any]), Family Name or Surname and Residence (City and either State or Foreign Country).
Additional inventors are being named on the number of separately numbered sheets attached hereto.
Title of the invention
Enter the TITLE OF THE INVENTION (500 characters max).
Correspondence address
Under Direct all correspondence to: CORRESPONDENCE ADDRESS, check The address corresponding to Customer Number and enter the Customer Number.
Or enter Firm or Individual Name, Address, City, State, Zip, Country, Telephone and Email.
Enclosed application parts
Under ENCLOSED APPLICATION PARTS (check all that apply), check Application Data Sheet. See 37 CFR 1.76.
Check CD(s) and enter the Number of CDs.
Check Drawing(s) and enter the Number of Sheets. Check Other (specify) and fill in the line.
Check Specification (e.g., description of the invention) and enter the Number of Pages.
Method of payment of the filing fee and application size fee
Check Applicant asserts small entity status. See 37 CFR 1.27.
Check Applicant certifies micro entity status. See 37 CFR 1.29. Applicant must attach form PTO/SB/15A or B or equivalent.
Check A check or money order made payable to the Director of the United States Patent and Trademark Office is enclosed to cover the filing fee and application size fee (if applicable), and enter the TOTAL FEE AMOUNT ($).
Check Payment by credit card. Form PTO-2038 is attached.
Check The Director is hereby authorized to charge the filing fee and application size fee (if applicable) or credit any overpayment to Deposit Account Number and enter the Account Number.
Made by an agency of the United States Government or under a contract with an agency
Under The invention was made by an agency of the United States Government or under a contract with an agency of the United States Government, check No. or check Yes, the invention was made by an agency of the U.S. Government and enter The U.S. Government agency name.
Or check Yes, the invention was made under a contract with an agency of the U.S. Government and enter The contract number and The U.S. Government agency name.
Providing this information on a provisional cover sheet, such as this Provisional Application for Patent Cover Sheet (Form PTO/SB/16), does not satisfy the requirement of 35 U.S.C. 202(c)(6), which requires that the specification contain a statement specifying that the invention was made with Government support and that the Government has certain rights in the invention.
Signature
Sign on the SIGNATURE line and enter the DATE.
Enter the TYPED OR PRINTED NAME and the REGISTRATION NO. (if appropriate).
Enter the TELEPHONE and the DOCKET NUMBER.
More rules for Form PTO/SB/16
A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with an information collection subject to the requirements of the Paperwork Reduction Act of 1995, unless the information collection has a currently valid OMB Control Number. The OMB Control Number for this information collection is 0651-0032.
Public burden for this form is estimated to average 18 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the information collection. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden to the Chief Administrative Officer, United States Patent and Trademark Office, P.O. Box 1450, Alexandria, VA 22313-1450 or email InformationCollection@uspto.gov. DO NOT SEND FEES OR COMPLETED FORMS TO THE CHIEF ADMINISTRATIVE OFFICER ADDRESS.
Petitioner/applicant is cautioned to avoid submitting personal information in documents filed in a patent application that may contribute to identity theft.
Personal information such as social security numbers, bank account numbers,or credit card numbers (other than a check or credit card authorization form PTO-2038 submitted for payment purposes) is never required by the USPTO to support a petition or an application.
If this type of personal information is included in documents submitted to the USPTO, petitioners/applicants should consider redacting such personal information from the documents before submitting them to the USPTO.
Petitioner/applicant is advised that the record of a patent application is available to the public after publication of the application (unless a non-publication request in compliance with 37 CFR 1.213(a) is made in the application) or issuance of a patent. Furthermore, the record from an abandoned application may also be available to the public if the application is referenced in a published application or an issued patent (see 37 CFR 1.14).
Checks and credit card authorization forms PTO-2038 submitted for payment purposes are not retained in the application file and therefore are not publicly available.
If you do not furnish the information requested on this form, the USPTO may not be able to process and/or examine your submission, which may result in termination of proceedings, abandonment of the application, and/or expiration of the patent.
Common questions about Form PTO/SB/16
Where do I file it?
If filing this completed form by mail, send to: Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313-1450.
Are there fees?
Fees Due: Filing Fee of $325 ($130 for small entity) ($65 for micro entity) (checked October 30, 2026). If the specification and drawings exceed 100 sheets of paper, an application size fee is also due, which is $450 ($180 for small entity) ($90 for micro entity) for each additional 50 sheets or fraction thereof. See 35 U.S.C. 41(a)(1)(G) and 37 CFR 1.16(s) (checked October 30, 2026).
Where to get help with Form PTO/SB/16
If you need assistance in completing the form, call 1-800-PTO-9199 and select option 2.
Sources
[1] Form PTO/SB/16 (01-25), Provisional Application for Patent Cover Sheet, U.S. Patent and Trademark Office (the Official source link on this page).
