Doc code: REIS.DECL Document Description: Reissue Declaration Filed In Accordance With MPEP 1414 PTO/$,$ (06-12) Approved for use through 01/31/2014. OMB 0651-003 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. SUBSTITUTE STATEMENT IN LIEU OF AN OATH OR DECLARATION FOR REISSUE PATENT APPLICATION (35 U.S.C. 115(d) AND 37 CFR 1.64) Title of Invention This statement is directed to: The attached application, OR was filed on ____________________ as reissue applicaWLon number ___________________. LEGAL NAME of inventor to whom this substitute statement applies: (E.g., Given Name (first and middle (if any)) and Family Name or Surname) Residence (except for a deceased or legally incapacitated inventor): City State Country Mailing Address (except for a deceased or legally incapacitated inventor): City Zip State Country I believe the above-named inventor or joint inventor to be the original inventor or an original joint inventor of a claimed invention in the application. The above-identified application was made or authorized to be made by me. I hereby acknowledge that any willful false statement made in this statement is punishable under 18 U.S.C. 1001 by fine or imprisonment of not more than five (5) years, or both. Relationship to the inventor to whom this substitute statement applies: Legal Representative (for deceased or legally incapacitated inventor only), Assignee, or Joint Inventor. Circumstances permitting execution of this substitute statement: Inventor is deceased, Inventor is under legal incapacity, Inventor cannot be found or reached after diligent effort, or Inventor has refused to execute the oath or declaration under 37 CFR 1.175. [Page 1 of 2] This collection of information is required by 35 U.S.C. 115 and 37 CFR 1.63. 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 1 minute 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. American LegalNet, Inc. If you need assistance in completing the form, call 1-800-PTO-9199 and select option 2. www.FormsWorkFlow.com PTO/$,$ (06-12) Approved for use through 01/31/2014. OMB 0651-003 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. SUBSTITUTE STATEMENT If there are joint inventors, please check the appropriate box below: An application data sheet under 37 CFR 1.76 (PTO/SB/14 or equivalent) naming the entire inventive entity has been or is currently submitted. OR An application data sheet under 37 CFR 1.76 (PTO/SB/14 or equivalent) has not been submitted. Thus, a Substitute Statement Supplemental Sheet (PTO/$,$ or equivalent) naming the entire inventive entity and providing inventor information is attached. See 37 CFR 1.64(b). I believe the original patent to be wholly or partly inoperative or invalid, for the reasons described below. (Check all boxes that apply.) by reason of a defective specification or drawing. by reason of the patentee claiming more or less than he had the right to claim in the patent. by reason of other errors. At least one error upon which reissue is based is described below. If the reissue is a broadening reissue, D FODLP WKDW WKH DSSOLFDWLRQ VHHNV WR EURDGHQ PXVW EH LGHQWLILHG: WARNING: Petitioner/applicant is cautioned to avoid submitting personal information in documents filed in a patent application that may contribute to identity theft. Personal information such as social security numbers, bank account numbers, or credit card numbers (other than a check or credit card authorization form PTO-2038 submitted for payment purposes) is never required by the USPTO to support a petition or an application. If this type of personal information is included in documents submitted to the USPTO, petitioners/applicants should consider redacting such personal information from the documents before submitting them to the USPTO. Petitioner/applicant is advised that the record of a patent application is available to the public after publication of the application (unless a non-publication request in compliance with 37 CFR 1.213(a) is made in the application) or issuance of a patent. Furthermore, the record from an abandoned application may also be available to the public if the application is referenced in a published application or an issued patent (see 37 CFR 1.14). Checks and credit card authorization forms PTO-2038 submitted for payment purposes are not retained in the application file and therefore are not publicly available. PERSON EXECUTING THIS SUBSTITUTE STATEMENT: Name: Date (Optional): Signature: Residence (unless provided in an application data sheet, PTO/SB/14 or equivalent): City Country State Mailing Address (unless provided in an application data sheet, PTO/SB/14 or equivalent) City Country Zip State Note: Use an additional PTO/$,$ form for each inventor who is deceased, legally incapacitated, cannot be found or reached after diligent effort, or has refused to execute the oath or declaration under 37 CFR 1.63. [Page 2 of 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. 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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