Get Combined Declaration And Power Of Attorney For Patent And Design Applications

Filling out the Combined Declaration And Power Of Attorney For Patent And Design Applications is an essential step in protecting your intellectual property. This guide provides clear instructions to help users navigate the form efficiently, ensuring a smooth online experience.

Follow the steps to complete your application online.

1. Press the ‘Get Form’ button to access the form and open it in the designated online tool.
2. Begin by entering your personal information in the 'Applicant Information' section. Fill in your first name, middle initial, last name, address, city, state, ZIP code, daytime phone number, email address, and identification number.
3. Indicate the date you last engaged in anesthesia practice using the format MM/DD/YYYY.
4. In the 'Sponsor/Site Information' section, provide the contact details for the Refresher Program Clinical Site Sponsor, including their email and daytime phone number.
5. Specify the clinical anesthesia refresher facility's address, including street, city, state, and ZIP code.
6. Record the expected enrollment date and expected completion date in the designated fields, using the MM/DD/YYYY format.
7. Prepare and attach the required materials to your application, including a typed statement from the Refresher Program clinical site sponsor outlining the clinical facility resources.
8. In the 'Sponsor/Applicant Agreement' section, read through the declaration and sign it, providing your signature and the date.
9. Finally, review the completed form for accuracy. Once you are satisfied that all information is correct, you can save your changes, download, print, or share the form as needed.

Take the next step in securing your intellectual property by completing your documents online today.