COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No. AO 120 (Rev. 3/04)Calendar No.REPORT ON THETO:FILING OR DETERMINATION OF AN ACTION REGARDING A PATENT ORJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)Mail Stop 8 Director of the U.S. Patent and Trademark Office P.O. Box 1450 Alexandria, VA 22313-1450TRADEMARKIn Compliance with 35 U.S.C. § 290 and/or 15 U.S.C. § 1116 you are hereby advised that a court action has been filed in the U.S. District Courton the followingG Patents orG Trademarks:DOCKET NO.DATE FILEDU.S. DISTRICT COURTPLAINTIFFDEFENDANT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .THE PEOPLE OF THE STATE OF NEW YORK TOPATENT OR TRADEMARK NO.DATE OF PATENT OR TRADEMARKHOLDER OF PATENT OR TRADEMARK12GREETINGS:34WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,5located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomIn the above entitled case, the following patent(s)/ trademark(s) have been included:DATE INCLUDEDINCLUDED BYG AmendmentG AnswerG Other PleadingG Cross BillYour failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.PATENT OR TRADEMARK NO.DATE OF PATENT OR TRADEMARKHOLDER OF PATENT OR TRADEMARK1, one of the Justices of the2Court in Witness, Honorableday of, 20 County,34(Attorney must sign above and type name below)5Attorney(s) forIn the above entitled case, the following decision has been rendered or judgement issued:DECISION/JUDGEMENTOffice and P.O. AddressCLERKDATE(BY) DEPUTY CLERKTelephone No.: Facsimile No.: E-Mail Address:Copy 1 Upon initiation of action, mail this copy to DirectorCopy 3 Upon termination of action, mail this copy to Director Copy 2 Upon filing document adding patent(s), mail this copy to DirectorMobile Tel. No.:Copy 4 Case file copyAmerican LegalNet, Inc. www.USCourtForms.com