PATENT COOPERATION TREATY From the INTERNATIONAL BUREAU PCT To: NOTIFICATION OF RECEIPT OF SUPPLEMENTARY SEARCH REQUEST AND PAYMENT OF APPLICABLE FEES (PCT Rules 45bis.2 and 45bis.3) Date of mailing (day/month/year) Applicant’s or agent’s file reference PAYMENT DUE see item 4 for time limit International application No. International filing date (day/month/year) Applicant 1. The International Bureau hereby notifies the applicant of receipt of the supplementary search request on _________________ (date). The Authority specified for supplementary search is __________________________ 2. The applicant is hereby notified that the International Bureau has received: the payment of all the prescribed fees, and an overpayment, which will be refunded in due course no or insufficient payment of the prescribed fees and the applicant is hereby invited to pay the balance due, as summarized under item 2, within the time limit indicated under item 3. 3. Fees and payment calculation: Supplementary search fee SS ______________________ Supplementary search SH handling fee* + _____________________ SS + SH = ____________________ – ____________________ = __________________________ Total fees payable Amount paid Balance due * Applicants from certain States are entitled to a reduction of 90% of the supplementary search handling fee. Where the applicant is (or all applicants are) so entitled, the amount to be entered is 10% of the supplementary search handling fee. See Notes to the Fee Calculation Sheet annexed to the Supplementary Search Request Form (PCT/IB/375) for details. 4. Time limit for payment and amount payable (Rules 45bis.2(c) and 45bis.3(c)) The prescribed fees are payable within ONE MONTH from the date of receipt of the supplementary search request (see above). The amount payable is the amount applicable on the date of payment. The International Bureau of WIPO 34, chemin des Colombettes 1211 Geneva 20, Switzerland Facsimile No. +41 22 338 82 70 Authorized officer Telephone No. +41 22 338 XX XX Form PCT/IB/376 (January 2009) American LegalNet, Inc. www.FormsWorkflow.com