USPTO 2021 NPADC IDSv3

Doc code: IDS
Doc description: Information Disclosure Statement (IDS) Filed

National Patent Application Drafting Competition
OMB control # 0690-0031 expires 08/31/2023

Under the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless it displays a valid OMB control number.

NPADC TEAM NUMBER:
Filing Date

INFORMATION DISCLOSURE
STATEMENT BY APPLICANT

First Named Inventor
Art Unit

( Not for submission under 37 CFR 1.99)

Examiner Name
Attorney Docket Number

U.S.PATENTS
Examiner Cite
Initial*
No

Patent Number

Kind
Issue Date
Code1

Pages,Columns,Lines where
Name of Patentee or Applicant
Relevant Passages or Relevant
of cited Document
Figures Appear

1

If you wish to add additional U.S. Patent citation information please click the Add button.
U.S.PATENT APPLICATION PUBLICATIONS
Examiner
Publication
Cite No
Initial*
Number

Kind Publication
Code1 Date

Pages,Columns,Lines where
Name of Patentee or Applicant
Relevant Passages or Relevant
of cited Document
Figures Appear

1

If you wish to add additional U.S. Published Application citation information please click the Add button.
FOREIGN PATENT DOCUMENTS
Examiner Cite Foreign Document
Initial*
No Number3

Country
Code2 i

Kind Publication
Code4 Date

Name of Patentee or
Applicant of cited
Document

Pages,Columns,Lines
where Relevant
T5
Passages or Relevant
Figures Appear

1

If you wish to add additional Foreign Patent Document citation information please click the Add button
NON-PATENT LITERATURE DOCUMENTS
Include name of the author (in CAPITAL LETTERS), title of the article (when appropriate), title of the item
Examiner Cite
(book, magazine, journal, serial, symposium, catalog, etc), date, pages(s), volume-issue number(s),
Initials* No
publisher, city and/or country where published.

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T5

NPADC TEAM NUMBER:

INFORMATION DISCLOSURE
STATEMENT BY APPLICANT
( Not for submission under 37 CFR 1.99)

Filing Date
First Named Inventor
Art Unit
Examiner Name
Attorney Docket Number

1

If you wish to add additional non-patent literature document citation information please click the Add button
EXAMINER SIGNATURE
Examiner Signature

Date Considered

*EXAMINER: Initial if reference considered, whether or not citation is in conformance with MPEP 609. Draw line through a
citation if not in conformance and not considered. Include copy of this form with next communication to applicant.
See Kind Codes of USPTO Patent Documents at www.USPTO.GOV or MPEP 901.04. 2 Enter office that issued the document, by the two-letter code (WIPO
Standard ST.3). 3 For Japanese patent documents, the indication of the year of the reign of the Emperor must precede the serial number of the patent document.
4 Kind of document by the appropriate symbols as indicated on the document under WIPO Standard ST.16 if possible. 5 Applicant is to place a check mark here if
English language translation is attached.
1

Paperwork Reduction Act Statement
Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. This Form is estimated to take 40 minutes to complete and submit to USPTO. Any comments on the
amount of time you require to complete this activity and/or suggestions for reducing this burden, should be sent to the Chief Administrative Officer, United States Patent and Trademark Office, P.O. Box 1450, Alexandria, VA 22313-1450.
Privacy Act Statement
The Privacy Act of 1974 (P.L. 93-579) requires that you be given certain information in connection with your registration to participate in an agency-sponsored activity, event, or program. The information in this system of records is to account for the electronic
collection, maintenance and use of information in connection with Department of Commerce activities, events, and programs. Such activities, events, and programs include, but are not limited to: Conferences, roundtable discussions, forums, exhibits,
summits, and presentations.
The authority for the collection of this information is 5 U.S.C. App.—Inspector General Act of 1978, § 2; 5 U.S.C. App.—Reorganization Plan
of 1970, § 2; 13 U.S.C. § 2; 13 U.S.C. § 131; 15 U.S.C. § 272; 15 U.S.C. § 1151; 15 U.S.C. § 1501; 15 U.S.C. § 1512; 15 U.S.C. § 1516; 15 U.S.C. § 3704b; 16 U.S.C. § 1431; 35 U.S.C. § 2; 42 U.S.C. § 3121 et seq.; 47 U.S.C. § 902; 50 U.S.C. App. § 2401
et seq.; E.O. 11625; 77 FR 49699 (Aug. 16, 1012) . The information in this system of records is used to manage Name, organization affiliation, title, address, email, and telephone number; credit card information; Web site URL; organization category and
description; business function; objectives for matchmaking; sponsorship information; exhibition booth preferences; and special requirements for exhibition needs; and all other information submitted to participate in an agency-sponsored activity, program, or
event. The information you provide is protected from disclosure to third parties in accordance with the Privacy Act.
However, routine uses of this information may include disclosure to the following: to other registrants to facilitate company/organization
matchmaking, to a Federal, state, local, or foreign agency or other appropriate entity where a record, either alone or in conjunction with other information, indicates a violation or potential violation of law, whether civil, criminal, or regulatory in nature, as
evidence to a court, magistrate or administrative tribunal, including disclosures to opposing counsel in the course of settlement negotiations, to a Member of Congress submitting a request involving an individual when the individual has requested assistance
from the Member with respect to the subject matter of the record, to the Office of Management and Budget in connection with the review of private relief legislation as set forth in OMB Circular No. A-19 at any stage of the legislative coordination and clearance
process as set forth in that Circular, to the Department of Justice in connection with determining whether disclosure thereof is required by the Freedom of Information Act, to a contractor of the Department having need for the information in the performance of
the contract, but not operating a system of records within the meaning of 5 U.S.C. § 552a(m), to the Administrator, General Services, or his designee, during an inspection of records conducted by GSA as part of that agency's responsibility to recommend
improvements in records management practices and programs, to appropriate agencies, entities, and persons when it is suspected or determined that the security or confidentiality of information in the system of records has been compromised. Disclosure of
the information by you is voluntary; however, failure to provide any part of the requested information may result in our inability to register you to participate in the agency-sponsored activity, event, or program. The applicable Privacy Act System of Records
Notice for this information request is COMMERCE/DEPT–23, Information Collected Electronically in Connection with Department of Commerce Activities, Events, and Programs: Federal Register / Vol. 78, No. 108 / Wednesday, June 5, 2013 / Notices 33807,
available at https://www.federalregister.gov/documents/2013/06/05/2013-13330/privacy-act-new-system-of-records

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Application Number

INFORMATION DISCLOSURE
STATEMENT BY APPLICANT
( Not for submission under 37 CFR 1.99)

Filing Date
First Named Inventor
Art Unit
Examiner Name
Attorney Docket Number

CERTIFICATION STATEMENT
Please see 37 CFR 1.97 and 1.98 to make the appropriate selection(s):
That each item of information contained in the information disclosure statement was first cited in any communication
from a foreign patent office in a counterpart foreign application not more than three months prior to the filing of the
information disclosure statement. See 37 CFR 1.97(e)(1).
OR
That no item of information contained in the information disclosure statement was cited in a communication from a
foreign patent office in a counterpart foreign application, and, to the knowledge of the person signing the certification
after making reasonable inquiry, no item of information contained in the information disclosure statement was known to
any individual designated in 37 CFR 1.56(c) more than three months prior to the filing of the information disclosure
statement. See 37 CFR 1.97(e)(2).

See attached certification statement.
The fee set forth in 37 CFR 1.17 (p) has been submitted herewith.
A certification statement is not submitted herewith.
SIGNATURE
A signature of the applicant or representative is required in accordance with CFR 1.33, 10.18. Please see CFR 1.4(d) for the
form of the signature.
Signature

Date (YYYY-MM-DD)

Name/Print

Registration Number

This collection of information is required by 37 CFR 1.97 and 1.98. The information is required to obtain or retain a benefit by the
public which is to file (and by the USPTO to process) an application. Confidentiality is governed by 35 U.S.C. 122 and 37 CFR
1.14. This collection is estimated to take 1 hour 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 and Trademark Office, U.S. Department of Commerce, P.O. Box 1450, Alexandria, VA 22313-1450. DO NOT SEND
FEES OR COMPLETED FORMS TO THIS ADDRESS. SEND TO: Commissioner for Patents, P.O. Box 1450, Alexandria,
VA 22313-1450.

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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 the collection 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 to process and/or examine your submission, which may
result in termination of proceedings or abandonment of the application or expiration of the patent.
The information provided by you in this form will be subject to the following routine uses:
1.

The information on this form will be treated confidentially to the extent allowed under the Freedom of Information Act
(5 U.S.C. 552) and the Privacy Act (5 U.S.C. 552a). Records from this system of records may be disclosed to the
Department of Justice to determine whether the Freedom of Information Act requires disclosure of these record s.

2.

A record from this system of records may be disclosed, as a routine use, in the course of presenting evidence to a
court, magistrate, or administrative tribunal, including disclosures to opposing counsel in the course of settlement
negotiations.

3.

A record in this system of records may be disclosed, as a routine use, to a Member of Congress submitting a
request involving an individual, to whom the record pertains, when the individual has requested assistance from the
Member with respect to the subject matter of the record.

4.

A record in this system of records may be disclosed, as a routine use, to a contractor of the Agency having need for
the information in order to perform a contract. Recipients of information shall be required to comply with the
requirements of the Privacy Act of 1974, as amended, pursuant to 5 U.S.C. 552a(m).

5.

A record related to an International Application filed under the Patent Cooperation Treaty in this system of records
may be disclosed, as a routine use, to the International Bureau of the World Intellectual Property Organization, pursuant
to the Patent Cooperation Treaty.

6.

A record in this system of records may be disclosed, as a routine use, to another federal agency for purposes of
National Security review (35 U.S.C. 181) and for review pursuant to the Atomic Energy Act (42 U.S.C. 218(c)).

7.

A record from this system of records may be disclosed, as a routine use, to the Administrator, General Services, or
his/her designee, during an inspection of records conducted by GSA as part of that agency's responsibility to
recommend improvements in records management practices and programs, under authority of 44 U.S.C. 2904 and
2906. Such disclosure shall be made in accordance with the GSA regulations governing inspection of records for this
purpose, and any other relevant (i.e., GSA or Commerce) directive. Such disclosure shall not be used to make
determinations about individuals.

8.

A record from this system of records may be disclosed, as a routine use, to the public after either publication of
the application pursuant to 35 U.S.C. 122(b) or issuance of a patent pursuant to 35 U.S.C. 151. Further, a record
may be disclosed, subject to the limitations of 37 CFR 1.14, as a routine use, to the public if the record was filed in
an application which became abandoned or in which the proceedings were terminated and which application is
referenced by either a published application, an application open to public inspections or an issued patent.

9.

A record from this system of records may be disclosed, as a routine use, to a Federal, State, or local law
enforcement agency, if the USPTO becomes aware of a violation or potential violation of law or regulation.

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