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Power Of Attorney Administrator Executor

IN THE UNITED STATES PATENT AND TRADEMARK OFFICE

In Patent of: [Name]

Patent No.:

Issued on: [Date]

For: [Item]

To the Honorable Commissioner of Patents and Trademarks:

I, [Name], as [dministrator of the estate or executor of the last will] of [Deceaseds Name], who was a resident of [Full Address], hereby appoint [Name, Full Address, and Phone Number] as my attorney and/or agent with full power of substitution, association, and revocation for the purpose of prosecuting Application Number [---] and for conducting all business in the Patent and Trademark Office in connection therewith.

All telephone calls and all correspondence should be addressed to the above named attorney and/or agent as follows:

Dated:

[Name]

[Telephone Number]

[Complete Address]

Signature

Full Name