PATENT COOPERATION TREATY From the INTERNATIONAL PRELIMINARY EXAMINING AUTHORITY PCT To: NOTIFICATION CONCERNING PAYMENT OF THE PRELIMINARY EXAMINATION AND HANDLING FEES (PCT Rules 57 and 58 and Administrative Instructions, Section 615) Date of mailing (day/month/year) Applicant’s or agent’s file reference PAYMENT DUE see item 3 for time limit International application No. International filing date (day/month/year) Applicant 1. The applicant is hereby notified that this International Preliminary Examining Authority 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. 2. Fees and payment calculation: Preliminary examination fee Handling fee* P ______________________ H + ______________________ Total fees payable = ______________________ – ________________________ = _____________________________ Amount paid Balance * Applicants from certain States are entitled to a reduction of 90% of the handling fee. Where the applicant is (or all applicants are) so entitled, the amount to be entered at H is 10% of the handling fee. See Notes to the Fee Calculation Sheet annexed to the Demand Form (PCT/IPEA/401) for details. 3. Time limit for payment and amount payable (Rules 57.3 and 58.1(b)): within ONE MONTH from the date on which the demand was submitted or 22 months from the priority date, whichever expires later; the amount payable is the amount applicable on the date of payment. within ONE MONTH from the date of receipt of the demand by this Authority (where the demand was transmitted to this Authority under Rule 59.3) or 22 months from the priority date, whichever expires later; the amount payable is the amount applicable on the date of payment. Name and mailing address of the IPEA/ Authorized officer Facsimile No. Telephone No. Form PCT/IPEA/403 (January 2009) American LegalNet, Inc. www.FormsWorkflow.com