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Form #860Declaration - Design Patent Application
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Declaration - Design Patent Application (free to use)
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DECLARATION
DESIGN PATENT APPLICATION
State of:Â
___________________________________
County of:Â
_________________________________
My name,
address, citizenship, and residence are as follows:
Full Name of
Inventor:Â _________________________________________________
Citizenship:Â
__________________________________________________________
Residence:Â
___________________________________________________________
Post Office
Address:Â ___________________________________________________
I believe I am
the original inventor of the design entitled ________________________ (Name of
Invention) which I have described and claimed in the attached specification.Â
To the best of my knowledge and belief, this design was never known or used in
the United States prior to my invention of it. Nor was it ever patented or
offered for public sale prior to that time. I recognize that I have a duty to
disclose material information pertaining to this application of which I am
aware.
To the best of
my knowledge and belief, all the statements made herein are true and were made
with the knowledge that willful false statements are unlawful and are
punishable by fine or imprisonment, or both.
___________________________________Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â ___________________
Signature                                                                              Date
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Keywords: Declaration, Design Patent, Legal Forms
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