PTO/AIA/17p (06-18) Approved for use through 11/30/2020. OMB 0651-0059 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 Enclosed is a petition filed under 37 CFR that requires a processing fee (37 CFR 1.17(f), (g), or (h)). Payment of $ is enclosed. This form should be included with the above-mentioned petition and faxed or mailed to the Office using the appropriate Mail Stop (e.g., Mail Stop Petition), if applicable. For transmittal of processing fees under 37 CFR 1.17(i), see form PTO/SB/17i. Applicant asserts small entity status. See 37 CFR 1.27. Applicant certifies micro entity status. See 37 CFR 1.29. Form PTO/SB/15A or B or equivalent must either be enclosed or have been submitted previously. Payment of Fees The Commissioner is hereby authorized to charge the following fees to Deposit Account No. : petition fee under 37 CFR 1.17(f), (g) or (h) any deficiency of fees and credit of any overpayments Check in the amount of $ is enclosed. Payment via EFS-Web. Payment by credit card (Form PTO-2038 or equivalent is enclosed). Do not provide credit card information on this form. Processing Fees Under 37 CFR 1.17(f): Undiscounted Fee $400 (Fee Code 1462) Small Entity Fee $200 (Fee Code 2462) Micro Entity Fee $100 (Fee Code 3462) For papers filed under: 247 1.36(a) - for revocation of a power of attorney by fewer than all of the applicants. 247 1.53(e) - to accord a filing date. 247 1.182 - for decision on a question not specifically provided for in an application for patent. 247 1.183 - to suspend the rules in an application for patent. 247 1.741(b) - to accord a filing date to an application under 247 1.740 for extension of a patent term. 247 1.1023(b) - to review the filing date of an international design application. Processing Fees Under 37 CFR 1.17(g): Undiscounted Fee $200 (Fee Code 1463) Small Entity Fee $100 (Fee Code 2463) Micro Entity Fee $50 (Fee Code 3463) For papers filed under: 247 1.12 - for access to an assignment record. 247 1.14 - for access to an application. 247 1.46 - for filing an application on behalf of an inventor by a person who otherwise shows sufficient proprietary interest in the matter. 247 1.55(f) - for filing a belated certified copy of a foreign application. 247 1.55(g) - for filing a belated certified copy of a foreign application. 247 1.57(a) - for filing a belated certified copy of a foreign application. 247 1.59 - for expungement of information. 247 1.103(a) - to suspend action in an application. 247 1.136(b) - for review of a request for extension of time when the provisions of 247 1.136(a) are not available. 247 1.377 - for review of decision refusing to accept and record payment of a maintenance fee filed prior to expiration of a patent. 247 1.550(c) - for patent owner requests for extension of time in ex parte reexamination proceedings. 247 1.956 - for patent owner requests for extension of time in inter partes reexamination proceedings. 247 5.12 - for expedited handling of a foreign filing license. 247 5.15 - for changing the scope of a license. 247 5.25 - for retroactive license. This collection of information is required by 37 CFR 1.17. 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 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 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. PROCESSING FEE Under 37 CFR 1.17(f), (g) & (h) TRANSMITTAL (Fees are subject to annual revision) [Page 1 of 2] Send completed form to: Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313-1450 Application Number Filing Date First Named Inventor Art Unit Examiner Name Practitioner Docket No. American LegalNet, Inc. www.FormsWorkFlow.com PTO/AIA/17p (06-18) Approved for use through 11/30/2020. OMB 0651-0059 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 Processing Fees Under 37 CFR 1.17(h): Undiscounted Fee $140 (Fee Code 1464) Small Entity Fee $70 (Fee Code 2464) Micro Entity Fee $35 (Fee Code 3464) For papers filed under: 247 1.19(g) - to request documents in a form other than provided in this part. 247 1.84 226 for accepting color drawings or photographs. 247 1.91 226 for entry of a model or exhibit. 247 1.102(d) 226 to make an application special. 247 1.138(c) - to expressly abandon an application to avoid publication. 247 1.313 226 to withdraw an application from issue. 247 1.314 - to defer issuance of a patent. PROCESSING FEE Under 37 CFR 1.17(f), (g) & (h) TRANSMITTAL [Page 2 of 2] SUBMITTED BY Signature Registration No. (Attorney/Agent) Telephone Name (Print/Type) Date 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 of Information Act (5 U.S.C. 552) and the Privacy Act (5 U.S.C 552a). Records from this system of records may be disclosed to the Department of Justice to determine whether disclosure of these records 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 presenting evidence to a court, magistrate, or administrative tribunal, including disclosures to opposing counsel in the course of settlement negotiations. 3. A record in this system of records may be disclosed, as a routine use, to a Member of Congress submitting a request involving an individual, to whom the record pertains, when the individual has requested 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 Agency having need for the information in order to perform a contract. Recipients of information shall be required 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 this system of records may be disclosed, as a routine use, to the International Bureau of the World Intellectual 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 for purposes of National Security review (35