USPTO Pro Bono Application

USPTO Pro Bono Application
Pro bono service request form – all information provided will be held in strict confidence.
This form is for applicants from DC, VA,and WV only. For information on other states, please visit the USPTO's website here.
Personal Information

First Inventor Only
First Name*
Middle Initial
Last Name*
Street Address*
Street Address 2*
City*
State (DC, VA, WV only)*
Zip Code*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Gender
Race
Ethnicity
U.S. Military Veteran
Are you a U.S. citizen or legal U.S. resident?*
What country are you a citizen of if not just the U.S.?
What country are you living in?*
What languages are you fluent in?*
Household Income*
enter USD amount with no symbols
Number of People in Household*
enter amount with no symbols
Patent / Invention Questions
Do you have now, or have had, the assistance of counsel with respect to a patent application?*

YesNo
Have you disclosed or published the invention?*

YesNo
Have you assigned your rights in your invention to anyone or any company?*

YesNo
Are there any time lines associated with any office actions to be aware of?*
How many patent applications have you filed?*
Do you currently have a provisional or non-provisional application filed with the USPTO? *

YesNo
If yes, and the application has been published what is the application number?
8 digit number
What is the application date?

MonthDayYear
Date
If no, have you completed the pro bono training program on the USPTO pro bono page and received a certificate of completion?

YesNo
Have you completed a prior art search?*

YesNo
If no, do you plan to do a prior art search?

YesNo
Write a brief abstract of your invention below.
Please describe the general technical area of your invention and the general improvement it provides. Do NOT include any confidential or novel features, and do NOT provide any specific details about your invention. Do not submit more than one application per invention.
Abstract:*

(1000 character limit)0/1000
Should be Empty:

USPTO Pro Bono Application

Personal Information

Patent / Invention Questions