PTO/SB/59 (09-16) Approved for use through /30/201. OMB 0651-0064 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. REQUEST FOR SUPPLEMENTAL EXAMINATION TRANSMITTAL FORM Address to: Commissioner for Patents Attorney Docket No.: P.O. Box 1450 Alexandria, VA 22313 - 1450 Date: 1. This is a request for supplemental examination pursuant to 37 CFR 1. 6 10 of patent number issued . 37 CFR 1.610(b)( 1 ). 2. Supplemental examination of claim(s) is requested. 37 CFR 1.610(b)( 4 ). 3 . a. The name (s) of the patent owner (s) ( not the patent practitioner(s)) is (are ) : b. A submission by the p atent owner (s) in compliance with 37 CFR 3.73( c ), which establishes that the patent owner (s) has (have) the entirety of the ownership in the patent for which supplemental examination is requested, is included. 3 7 CFR 1.610(b)( 9 ). 4 . a .A check in the amount of $ is enclosed to cover the fee for processing and treat ing a request for supplemental examination , the fee for reexamination ordered under 35 USC 257, and the fee for processing and treating each non - patent document over 20 sheets in length ( 37 CFR 1.20( k )(1 - 3 ) ) ; b.The Director is hereby authorized to charge all applicable fee s as set forth in 37 CFR 1.20( k )(1 - 3 ) to Deposit Accou nt No. ; or c. Payment by credit card. Form PTO - 2038 is attached. 37 CFR 1.610(a). 5 . Any refund should be made by check or credit to Deposit Account No. . 37 CFR 1.26(c). If payment is made by credit card, refund must be to the credit card account. 6 . A copy of the patent for which supplemental examination is requested , a nd a copy of any disclaimer or certificate issued for the patent are included . 37 CFR 1. 6 10(b)( 6 ) . 7 . CD - ROM or CD - R in duplicate, Computer Program (Appendix) or large table Landscape Table on CD 8 . Nucleotide and/or Amino Acid Sequence Submission If applicable, items a. c. are required. a. Computer Rea dable Form (CRF) b. Specification Sequence Listing on: i. CD - ROM (2 copies) or CD - R (2 copies); or ii. paper c. Statements verifying the identity of above copies 9 . A list of no more than 12 items of information submitted as part of this request is provided in Part B of this form. Where appropriate, the list must meet the requirements of 37 CFR 1.98(b). 37 CFR 1.605(a), 1.610(b)(2). [Page 1 of 2] This collection of information is required by 37 CFR 1.610. 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 0.3 hours 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. American LegalNet, Inc. www.FormsWorkFlow.com PTO/SB/59 (09-16) Approved for use through /30/201. OMB 0651-0064 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. 10. A legible copy of each item of information listed in Part B of this form, and an English language translation of all necessary and pertinent parts of each non - English language item of information are included. Copies of items of information that form part of the discussion within the body of the request (see 37 CFR 1.605(b) ) , and copies of U.S. paten ts and patent application publications, are not required. 37 CFR 1.610(b)(7). 1 1 . A summary of the relevant portions of each non - patent document that is over 50 pages in length (other than the request) is included. The summary includes the required citations to the particular pages containing the relevant portions. 37 CFR 1.610(b)( 8 ). 1 2 . A separate, detailed explanation of the relevance and manner of applying each item of informat ion to each claim of the patent for which supplemental examination is requested, is included . 37 CFR 1.610(b)(5). 13 . The below list includes all pr ior or concurrent post - patent Office proceedings ( ex parte or inter partes reexam ination , reissue, supplemental examination, post grant review, or inter partes review) involving the patent for which supplemental examination is being requested. 37 CFR 1.610(b)( 3 ). An identifying number may be, e.g., a control no. or reissue applicatio n no. Any prior or concurrent post - patent Office proceedings not listed below are listed on a separate paper accompanying the request . Type of Proceeding Identifying Number Filing Date See a ccompanying paper for a list of additional prior or concurrent post - patent Office proceedings involving the patent for which s upplemental examination is requested. The p - - patent Office proceeding. 1 4 .Correspondence Address: Please recognize , or change , the correspondence address for the file of the patent for which supplemental examination is requested and for the supplemental examination proceeding to be: The address associated with Customer Number: OR R Firm or Individual Name Address City State Zip Country Telephone Email 1 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 PTO - 2038. Authorized Signature Date Typed/Printed Name Registration No. [Page 2 of 2] Patent No. American LegalNet, Inc. www.FormsWorkFlow.com PTO/SB/59 (09-16) Approved for use through /30/201. OMB 0651-0064 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. (Also referred to as FORM PT O - XXXX) REQUEST FOR SUPPLEMENTAL EXAMINATION TRANSMITTAL FORM PART B LIST OF ITEMS OF INFORMATION Page 1 Patent number for which supplemental examination is requested Issue Date All items of information (no more than 12) submitted herewith as part of this request for supplemental examination of the above-identified patent are included in the following list: U. S. PATENT DOCUMENTS Cite No. 1 Document Number Publication Date MM - DD - YYYY Name of Patentee or Applicant of Cited Document Pages, Columns, Lines, Where Relevant Passages or Relevant Figures Appear Number - Kind Code 2 (if known) US - US - US - US - US - US - US - US - US - US - US - US - FOREIGN PATENT DOCUMENTS Cite No. 1 Foreign Patent Document Publication Date MM - DD - YYYY Name of Patentee or Applicant of Cited Document Pages, Columns, Lines, Where Relevant Passages or Relevant Figures Appear Country Code 3 - Number 4 - Kind Code 5 (if known) T 2 1 2 See Kinds Codes of USPTO Patent Documents at www.uspto.gov or MPEP 901.04. 3 Enter Office that issued the document, by the two-letter code (WIPO Standard ST.3). 4 For Japanese patent documents, the indication of the year of the reign of the Emperor must precede the serial number of the patent document. 5Kind of document by the appropriate symbols as indicated on the document under WIPO Standard ST.16 if possible. 6 Applicant is to place a check mark here if English language Translation is attached. Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com PTO/SB/59 (09-16) Approved for use through /30/201. OMB 0651-0064 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. (Also referred to as FOR M PTO - XXXX) REQUEST FOR SUPPLEMENTAL EXAMINATION TRANSMITTAL FORM PART B LIST OF ITEMS OF INFORMATION Page 2 Patent numbe