Inventor Application for Assistance – Ohio Patent Pro Bono Program

Thank you for your interest in the Patent Pro Bono Program for Ohio. To apply for legal assistance from the program, please fill out and submit this form. We will contact you about the next steps once we complete an initial review of your information and determine if you are eligible for assistance.

We do our best to help as many applicants as possible. Unfortunately, we cannot guarantee that every eligible applicant will be matched with a volunteer attorney.

The Ohio Patent Pro Bono Program will use and disclose your information only to the extent necessary and appropriate. By submitting your application, you give us consent to disclose your information to volunteer law firms and lawyers who may consider assisting you. (* = Required Field)

First Name*

Last Name*

Email*

Home Phone*

Mobile

Country

Street

City

State

Zip

Website

Are you a US citizen or legal US resident?

Are you a citizen of any other country?

What country do you live in?

What languages do you speak fluently?

What is your annual household income?

How many people are in your household?

Invention type

If you selected “other,” please describe your invention type here.

Briefly describe your invention. What kind of technology is it? What does it improve? Do NOT describe any confidential or novel features or give any specific details. 0

Have you consulted with an attorney about your invention?

When was the first time you published or disclosed details about your invention?

Have you assigned your ownership of the invention to anyone else?

Have you already filed a patent application? What kind? Select “None” if you haven’t yet filed any type of application.

When did you file the application?

What is the application number?

Please indicate the due date of any pending USPTO office action.

Have you already done a prior art search?

Have you completed the USPTO’s “Basic Patent Training for Independent Inventors and Small Businesses” online training program?

Are there any other pending deadlines affecting your invention that we should know about?

PTO 450 (Rev.4/20) Approved for use through 06/30/2023. OMB 0651-0082 U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number

THE ANSWERS TO THE FOLLOWING 4 QUESTIONS WILL BE KEPT IN CONFIDENCE AND WILL ONLY BE USED IN THE AGGREGATE.

WHAT IS YOUR GENDER?*

WHAT IS YOUR RACE?*

ARE YOU A VETERAN?*

ARE YOU OF HISPANCI, LATINO OR SPANISH ORIGIN OR ETHNICITY?*

Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB Control Number. Response to this information collection is voluntary; however, the data collected from this survey will be used to evaluate and publicize the Patent Pro Bono Program. Any comments on the amount of time you require to complete this survey and/or suggestions for reducing this burden, should be sent to the Chief Administrative Officer, United States Patent and Trademark Office P.O. Box 1450, Alexandria, VA 22313-1450.