A Standard Document providing a sample pre-appeal brief request for review that a patent applicant may file with a notice of appeal in an appeal-eligible patent application. This sample request for review includes language seeking reconsideration of the examiner's decision and reflects the requirements under the pre-appeal brief conference pilot program and Manual of Patent Examining Procedure (MPEP) Section 1204.02. This Standard Document has integrated drafting notes with important explanations and drafting tips.