Reissue Patent Application Transmittal Form. This is a Official Federal Forms form and can be use in Patent US Patent Office.
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PTO/$,$/50 (0-) Approved for use through 08/31/201. 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. REISSUE PATENT APPLICATION TRANSMITTAL Attorney Docket No. Address to: First Named Inventor Mail Stop Reissue Commissioner for Patents P.O. Box 1450 Alexandria, VA 22313-1450 Original Patent Number Original Patent Issue Date (Month/Day/Year) Express Mail Label No. APPLICATION FOR REISSUE OF: (Check applicable box) Utility Patent APPLICATION ELEMENTS (37 CFR 1.173) Design Patent ACCOMPANYING APPLICATION PARTS Fee Transmittal Form (PTO/SB/56) 1. Plant Patent Applicant claims small entity status. See 37 CFR 1.27. 3. Specification and Claims in double column copy of patent format (amended, if appropriate) 4. 11. 3RZHU RI $WWRUQH\ Information Disclosure Statement (IDS) Drawing(s) (proposed amendments, if appropriate) 5. Statement of status and support for all changes to the claims. See 37 CFR 1.173(c). 12. 2. 10. Reissue Oath/Declaration RU 6XEVWLWXWH 6WDWHPHQW (37 C.F.R. 1.175) (PTO/$,$/ RU ) $SSOLFDWLRQ 'DWD 6KHHW NOTE: %HQHILW FODLPV XQGHU &)5 DQG IRUHLJQ SULRULW\ FODLPV XQGHU &)5 0867 EH VHW IRUWK LQ DQ $SSOLFDWLRQ 'DWD 6KHHW ($'6) Original U.S. Patent currently assigned? Yes No (If Yes, check applicable box(es)) 6. 7. Copies of citations attached 37 CFR 3.73(F) Statement (PTO/SB/96) CD-ROM or CD-R in duplicate, Computer Program (Appendix) or large table Landscape Table on CD 13. English Translation of Reissue Oath/Declaration (if applicable) 14. Preliminary Amendment 15. Written Consent of all Assignees (PTO/SB/53) 8. PTO/SB/08 or PTO-1449 Return Receipt Postcard (MPEP 503) (Should be specifically itemized) 16. Other: 9. Nucleotide and/or Amino Acid Sequence Submission (if applicable, items a. – c. are required)) a. Computer Readable Form (CRF) b. Specification Sequence Listing on: i CD-ROM (2 copies) or CD-R (2 copies); or ii paper c. Statements verifying identity of above copies 7KLV LV D FRQWLQXDWLRQ UHLVVXH RU GLYLVLRQDO UHLVVXH DSSOLFDWLRQ i.e. D VHFRQG RU VXEVHTXHQW UHLVVXH DSSOLFDWLRQ IRU WKH VDPH LVVXHG SDWHQW (Check box if applicable) 17. CORRESPONDENCE ADDRESS OR The address associated withCustomer Number: Correspondence address below Name Address City Country Signature Name (Print/Type) State Telephone Zip Code Email Date Registration No. (Attorney/Agent) This collection of information is required by 37 CFR 1.173. 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 and 1.14. This collection is estimated to take 12 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: Mail Stop Reissue, 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 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. 2. 3. 4. 5. 6. 7. 8. 9. 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. 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. 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. 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). 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. 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 U.S.C. 181) and for review pursuant to the Atomic Energy Act (42 U.S.C. 218(c)). A record from this system of records may be disclosed, as a routine use, to the Administrator, General Services, or his/her designee, during an inspection of records conducted by GSA as part of that agency’s 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 the GSA regulations governing inspection of records for this purpose, and any other relevant (i.e., GSA or Commerce) directive. Such disclosure shall not be used to make determinations about individuals. A record from this system of records may be disclosed, as a routine use, to the public after either publication of the application pursuant to 35 U.S.C. 122(b) or issuance of a patent pursuant to 35 U.S.C. 151. Further, a record may be disclosed, subject to the limitations of 37 CFR 1.14, as a routine use, to the public if the record was filed in an application which became abandoned or in which the proceedings were terminated and which application is referenced by either a published application, an application open to public inspection or an issued patent. A record from this system of records may be disclosed, as a routine use, to a Federal, State, or local law enforcement agency, if the USPTO becomes aware of a violation or potential violation of law or regulation. American LegalNet, Inc. www.FormsWorkFlow.com