Power of Attorney Administrator Executor



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:

I, _____ (Name), as ________ (administrator of the estate or executor of the last will) of ______ (Deceased's Name), who was a resident of ______ (Give Complete Address), hereby appoint (Give Name, Full Address, and Phone Number) as my attorney and/or agent with full power of substitution, association, and revocation for the purpose of prosecuting Application Number ________ and for conducting all business in the Patent and Trademark Office in connection therewith.

All telephone calls and all correspondence should be addressed to the above named attorney and/or agent as follows:

_________________ (Name)

_________________ (Telephone Number)

_________________ (Complete Address)

___________________________________

Signature

Date: __________