Design Patent Application—Preamble, Specification,
and Claim

Mail Stop Design
Commissioner for Patents
P.O. Box 1450
Alexandria, VA 22313-1450

Sir:

PREAMBLE:

The petitioner(s) whose signature(s) appear on the declaration attached respectfully request that Letters Patent be granted to such petitioner(s) for the new and original design set forth in the following specification. The filing fee of $ __________, _____________ sheets of drawings, a patent application declaration, fee transmittal, a credit card payment form or check, and a return receipt postcard are attached.

SPECIFICATION:
The undersigned has (have) invented a new, original, and ornamental design entitled “___________________________” of which the following is a specification. Reference is made to the accompanying drawings that form a part hereof, the figures of which are described as follows:

CROSS-REFERENCE TO RELATED APPLICATIONS:

STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH:

DRAWING FIGURES: 

Claim: I (We) Claim:
The ornamental design for a _______________________________________________, as shown.

Express Mail Label # __________________________; Date of Deposit 20	 ___________