Fee Transmittal Form. This is a Official Federal Forms form and can be use in Patent US Patent Office.
Tags: Fee Transmittal, PTO-SB-17, Official Federal Forms US Patent Office, Patent
PTO/SB/17 (10‐12) Approved for use through 01/31/2014. OMB 0651‐0032 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 FEE TRANSMITTAL Applicant claims small entity status. See 37 CFR 1.27 TOTAL AMOUNT OF PAYMENT ($) Complete if known Filing Date First Named Inventor Examiner Name Art Unit Practitioner Docket No. Application Number METHOD OF PAYMENT (check all that apply) Check Credit Card Money Order None Other (please identify): ___________________________________________ Deposit Account Deposit Account Number: _______________________ Deposit Account Name: ______________________ For the above‐identified deposit account, the Director is hereby authorized to (check all that apply): Charge fee(s) indicated below Charge fee(s) indicated below, except for the filing fee Charge any additional fee(s) or underpayment of fee(s) Credit any overpayment of fee(s) under 37 CFR 1.16 and 1.17 WARNING: Information on this form may become public. Credit card information should not be included on this form. Provide credit card information and authorization on PTO‐2038. FEE CALCULATION 1. BASIC FILING, SEARCH, AND EXAMINATION FEES Application Type Utility Design Plant Reissue Provisional Fee ($) 390 250 250 390 250 FILING FEES Small Entity Fee ($) 195 125 125 195 125 Fee ($) 620 120 380 620 0 SEARCH FEES Small Entity Fee ($) 310 60 190 310 0 EXAMINATION FEES Fee ($) Small Entity Fee ($) 250 125 160 80 200 100 760 380 0 0 Fees Paid ($) 2. EXCESS CLAIM FEES Fee Description Each claim over 20 (including Reissues) Each independent claim over 3 (including Reissues) Multiple dependent claims Extra Claims Fee ($) Total Claims __________ ‐20 or HP = __________ x __________ = HP = highest number of total claims paid for, if greater than 20. Indep. Claims Extra Claims Fee ($) __________ ‐3 or HP = __________ x __________ = HP = highest number of independent claims paid for, if greater than 3. Fee ($) 62 250 460 Fee Paid ($) __________ Fee Paid ($) __________ Small Entity Fee ($) 31 125 230 Multiple Dependent Claims Fee ($) Fee Paid ($) __________ __________ 3. APPLICATION SIZE FEE If the specification and drawings exceed 100 sheets of paper (excluding electronically filed sequence or computer listings under 37 CFR 1.52(e)), the application size fee due is $320 ($160 for small entity) for each additional 50 sheets or fraction thereof. See 35 U.S.C. 41(a)(1)(G) and 37 CFR 1.16(s). Total Sheets Extra Sheets Number of each additional 50 or fraction thereof Fee ($) Fee Paid ($) __________ ‐ 100 = __________ / 50 = __________ (round up to a whole number) x __________ = __________ 4. OTHER FEE(S) Fees Paid ($) Non‐English specification, $130 fee (no small entity discount) __________ Non‐electronic filing fee under 37 CFR 1.16(t) for a utility application, $400 fee ($200 small entity) __________ Other (e.g., late filing surcharge): _______________________________________________________________________ __________ SUBMITTED BY Signature Name (Print/Type) Registration No. (Attorney/Agent) Telephone Date This collection of information is required by 37 CFR 1.136. The information is required to obtain or retain a benefit by the public which is to file (and by the USPTO to process) an application. Confidentiality is governed by 35 U.S.C. 122 and 37 CFR 1.14. This collection is estimated to take 30 minutes to complete, including gathering, preparing, and submitting the completed application form to the USPTO. Time will vary depending upon the individual case. Any comments on the amount of time you require to complete this form and/or suggestions for reducing this burden, should be sent to the Chief Information Officer, U.S. Patent and Trademark Office, U.S. Department of Commerce, P.O. Box 1450, Alexandria, VA 22313‐1450. DO NOT SEND FEES OR COMPLETED FORMS TO THIS ADDRESS. SEND TO: Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313‐1450. If you need assistance in completing the form, call 1‐800‐PTO‐9199 and select option 2. American LegalNet, Inc. www.FormsWorkFlow.com