Patent Application Information Sheet

Title
First Name
Last Name
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Primary Email
Secondary Email
Website URL
Phone
You want to apply
In Your Own NameIn the Name of Your CompanyOther
Entity Type If applicant is other than an individual
Entity Size
Entity Name/Title
Business Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Business eMail
Business Phone

Type of Patent you want to apply
File Upload Any information material about the proposed patent. Don't attach the Patent Documents. The documents will be received via eMail/Secured System after discussion.
Other instructions by you (if any)