PTO/SB/52 (09-12) Approved for use through 01/31/2020. OMB 0651-0033 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. Docket Number (optional) REISSUE APPLICATION DECLARATION BY THE ASSIGNEE I hereby declare that: The residence, mailing address and citizenship of the inventors are stated below. I am authorized to act on behalf of the following assignee: and the title of my position with said assignee is: The entire title to the patent identified below is vested in said assignee. Inventor Residence/Mailing Address Inventor Residence/Mailing Address Additional Inventors are named on separately numbered sheets attached hereto. 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