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`
`
`
`PATENT APPLIC
`ON FEE DETERMINATION RECORD
`~
`Effective December 8, 2004
`
`Application or Docket Number
`
`
`
`
`
`
`
`
`'
`
`SMALL ENTITY
`omen THAN
`
`
`TYPE a QR
`SMALL ENTITY
`
`
`
`
`
`
`
`
`
`
`
`- CLAIMS As FILED - PART I
`(Column 1)
`us. NATIONAL STAGE FEES —
`- “——
`
`
`4
`
`
`
`
`'
`
`‘
`
`(Column'2) '
`
`'
`WW" FEE
`
`Satisfies PCT Articte 33(1)-
`
`All other situations ’-'
`
`_
`.
`.
`USJSI$A=$50I$100
`ALL othercountries = Mam '
`3 200 I {400
`
`’
`
`'
`
`
`
`SMALL ENTITYV
`
`QR
`
`OTHERHTHAN
`SMALL ENTITY
`ADDI-
`TIONAL
`FEE
`
`RATE
`
`
`
`
`
`FEE
`
`
`
`
`
`minus 20 =_
`]
`OTA'L CHARGEABLE CLAIMS
`mow
`, m_ .
`MUL‘I'IPLE DEPENDENT CLAIM PRESENT
`[j
`.
`g;
`I
`lfthe difference in column 1 is less than zero. enter “0".In column 2
`
`CLAIMS AS AMENDED - PART II
`_
`(Column 1)
`.
`,
`-
`(Column 2’
`NUMBER
`PREVIOUSLY
`
`(Column 3)
`PRESENT
`EXTRA
`
`I
`
`
`
`
`
`
`AM'ENoMENTA
`
`
`
`
`FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM U
`
`
`
`AMENDMENTB
`X 69 0!o'
`-O
`OR X$200= -
`
`0R +5360: -
`
`TOTAL ADDIT.
`OR
`FEE
`'
`
`
`.‘Ithe entty in column 1 Is less than the entry in column 2. write "0' in column 3.
`
`“ l'the "Highest Number Previousty Paid For' IN THIS SPACE is less than '20'. entet '20-.
`
`‘“we “Highest Number Previously Paid For“ IN THIS SPACE is less than '3', enter'31
`
`
`The “Highest Number Previously Paid For' (Total or Independent) Is the h
`
`
`m
`
`
`
`

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