Maintenance Fee Transmittal Form. This is a Official Federal Forms form and can be use in Patent US Patent Office.
Tags: Maintenance Fee Transmittal Form, PTO-SB-45, Official Federal Forms US Patent Office, Patent
PTO/SB/45 (0313) Approved for use through 0/3/201. OMB 06510016 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. MAINTENANCE FEE TRANSMITTAL FORM (Do not submit this form electronically via EFSWeb) Address to: Director of the United States Patent and Trademark Office Attn: Maintenance Fee 2051 Jamieson Avenue, Suite 300 Alexandria, VA 22314 OR 226 Fax to: 5712736500 I hereby certify that this correspondence is being deposited with the United States Postal Service with sufficient postage as first class mail in an envelope addressed to 223Director of the United States Patent and Trademark Office, Attn: Maintenance Fee, 2051 Jamieson Avenue, Suite 300, Alexandria, VA 22314224 on Signature Typed or printed name Enclosed herewith is the payment of the maintenance fee(s) for the listed patent(s). 1. A check for the amount of $ for the full payment of the maintenance fee(s) and any necessary surcharge is enclosed.2. Payment by credit card. Form PTO2038 is enclosed. 3. The Director is hereby authorized to charge $ to cover the payment of the fee(s) indicated below toDeposit Account No. . 4. The Director is hereby authorized to charge any deficiency in the payment of the required fee(s) or credit any overpayment toDeposit Account No. . Item Patent U.S. Application Maintenance Surcharge Payment Year Number* Number* Fee Amount Amount (select one below) [e.g., 08/555,555] (37 CFR 1.20(e)(g) (37 CFR 1.20(h)) Column 5 1 Column Column Column23 Column 4 3.5 yrs 7.5 yrs 11.5 yrs 1 2 3 4 5 Subtotals: Columns 3 & 4 additional sheets attached for listing additional patents. Total Payment * Information required by 37 CFR 1.366(c) (columns 1 & 2). Information requested under 37 CFR 1.366(d) (columns 3, 4, & 5). 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 Form PTO2038. Respectfully submitted,** Customer222s Signature Customer222s Name Registration Number, if applicable: Telephone: Fax: Note: All correspondence will be forwarded to the 223Fee Address224 or to the 223Correspondence Address224 if no 223Fee Address224 has been provided. See 37 CFR 1.363. Payment of small entity fee is appropriate if small entity status still exists, see 37 CFR 1.27(g). To establish small entity status or to notify of a loss of entitlement to small entity status, a written assertion is required. See 37 CFR 1.27 and 1.33(b). Payment of micro entity fee is appropriate if patent owner certifies micro entity status. Form PTO/SB/15A or B or equivalent must either be enclosed or have been submitted previously. To notify of a loss of entitlement to micro entity status, a written assertion is required. See 37 CFR 1.29 and 1.33(b). ** WHERE MAINTENANCE FEE PAYMENTS ARE TO BE MADE BY AUTHORIZATION TO CHARGE A DEPOSIT ACCOUNT, BOTH THE NAME AND SIGNATURE OF AN AUTHORIZED USER ARE REQUIRED. This collection of information is required by 37 CFR 1.366. 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 1.11, 1.14 and 41.6. This collection is estimated to take 5 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 223131450. DO NOT SEND FEES OR COMPLETED FORMS TO THIS ADDRESS. SEND TO: Director of the United States Patent and Trademark Office, Attn: Maintenance Fee, 2051 Jamieson Avenue, Suite 300, Alexandria, VA 22314. If you need assistance in completing the form, call 1800PTO9199 and select option 2. American LegalNet, Inc. www.FormsWorkFlow.com Privacy Act Statement The Privacy Act of 1974 (P.L. 93-579) requires that you be given certain information in connection with your submission of the attached form related to a patent application or patent. Accordingly, pursuant to the requirements of the Act, please be advised that: (1) the general authority for the collection of this information is 35 U.S.C. 2(b)(2); (2) furnishing of the information solicited is voluntary; and (3) the principal purpose for which the information is used by the U.S. Patent and Trademark Office is to process and/or examine your submission related to a patent application or patent. If you do not furnish the requested information, the U.S. Patent and Trademark Office may not be able to process and/or examine your submission, which may result in termination of proceedings or abandonment of the application or expiration of the patent. The information provided by you in this form will be subject to the following routine uses: 1.The information on this form will be treated confidentially to the extent allowed under the Freedom ofInformation Act (5 U.S.C. 552) and the Privacy Act (5 U.S.C 552a). Records from this system ofrecords may be disclosed to the Department of Justice to determine whether disclosure of theserecords is required by the Freedom of Information Act.2.A record from this system of records may be disclosed, as a routine use, in the course of presentingevidence to a court, magistrate, or administrative tribunal, including disclosures to opposing counsel inthe course of settlement negotiations.3.A record in this system of records may be disclosed, as a routine use, to a Member of Congresssubmitting a request involving an individual, to whom the record pertains, when the individual hasrequested assistance from the Member with respect to the subject matter of the record.4.A record in this system of records may be disclosed, as a routine use, to a contractor of the Agencyhaving need for the information in order to perform a contract. Recipients of information shall berequired to comply with the requirements of the Privacy Act of 1974, as amended, pursuant to 5 U.S.C.552a(m).5.A record related to an International Application filed under the Patent Cooperation Treaty in thissystem of records may be disclosed, as a routine use, to the International Bureau of the WorldIntellectual Property Organization, pursuant to the Patent Cooperation Treaty.6.A record in this system of records may be disclosed, as a routine use, to another federal agency forpurposes of National Security review (35 U.S.C. 181) and for review pursuant to the Atomic Energy Act(42 U.S.C. 218(c)).7.A record from this system of records may be disclosed, as a routine use, to the Administrator, GeneralServices, or his/her designee, during an inspection of records conducted by GSA as part of thatagency222s responsibility to recommend improvements in records management practices and programs,under authority of 44 U.S.C. 2904 and 2906. Such disclosure shall be made in accordance with theGSA regulations governing inspection of records for this purpose, and any other relevant (i.e., GSA orCommerce) directive. Such disclosure shall not be used to make determinations about individuals.8.A record from this system of records may be disclosed, as a routine use, to the public after eitherpublication of the application pursuant to 35 U.S.C. 122(b) or issuance of a patent pursuant to 35U.S.C. 151. Further, a record may be disclosed, subject to the limitations of 37 CFR 1.14, as a routineuse, to the public if the record was filed in an application which became abandoned or in which theproceedings were terminated and which application is referenced by either a published application, anapplication open to public inspection or an issued patent.9.A record from this system of records may be disclosed, as a routine use, to a Federal, State, or locallaw enforcement agency, if the USPTO becomes aware of a violation or potential violation of law orregulation. American LegalNet, Inc. www.FormsWork