PTO/SB/oe (10—07)
`.
`Approved for use through 06/30/2010. OMB 0651-0032
`‘
`,
`US. Patent and TrademarkOffice; US. DEPARTMENT OF COMMERCE
`_
`-
`_
`.
`y
`,
`.
`‘
`Under the Pa - erwork Reduction Act of 1995 no -ersons are reouired to resend to a collection of information unless it dis -la 3 a valid OMB control number.
`
`
`
`PATENT APPLICATION FEE DETERMINATION RECORD
`App'mm" °'°,°°k°m"mb°'
`
`
`'
`V Substitute for Form PTO-875
`(1 ) 7 ‘ LO
`
`r
`
`
`
`APPLICATIONAS FILED — PART I
`(column 1)
`(cmumn 2)
`
`_
`
`g
`
`_
`
`’
`
`SMALL ENTITY
`
`0R
`
`OTHER THAN
`' SMALL ENTITY
`
`
`
`
`l
`
`
`O.\N\'.
`
`
`
`
`
`
`
`
`
`
`
`RATE s
`E
`
`S
`
`S
`
`$310
`
`$210
`
`.OR
`
`X350=
`
`-x 3210 .=‘
`
`$370
`
`TOTAL
`
`RATE $
`
`EE
`
`_
`
`S
`
`x $25= "
`
`X 3105} =
`
`TOTAL .
`
`RATE ($)
`,
`
`.
`
`
`
`.
`
`
`
`ADDI- I
`.
`TIONAL
`FEE s
`
`RATE (3)
`'
`
`' OTHER THAN
`SMALL ENTITY
`
`
`ADDI-
`TIONAL
`
`FEE s
`
`-
`(Column 3)
`
`,
`SMALL ENTITY
`
`of; ‘
`
`-
`4
`
`'
`
`NUMBER FILED
`NUMBER EXTRA
`I
`BASICFEE
`N/A
`.
`.
`37CFR1.168.° -_
`SEARCH FEE
`.
`N/A ,
`‘
`NIA
`_
`i
`'
`(370FR1.16(k).(i).cr(m))
`.
`N/A
`
`(37 0FR1-16(°).(P).0f(q))
`TOTAL CLAIMS
`
`-
`
`'
`
`‘
`
`INDEPENDENT CLAIMS
`(371.1601))
`- m-
`
`
`_If the Specification and drawings exceed 100
`APPLICATION SIZE
`sheets of paper. the application size fee due
`FEE
`is $260 ($130 for small entity) for each
`-(37 CFR 1.16(s))
`additional 50 sheets or fraction thereof. See
`35 U.S.C. 41 a 1 G and 37 CFR 1.16 s
`
`,
`
`
`
`-
`j
`
`
`
`MULTIPLE DEPENDENT CLAIM PRESENT (37 CFR‘1.16(j))I .
`
`' If the difference in column 1 is less than zero. enter '0' in column 2.
`
`APPLICATION AS AMENDED - PART ii
`'
`'
`,
`
`(Column 1)
`CLAIMS
`REMAINING
`- AFTER
`AMENDMENT
`
`'
`
`(Column 2)
`HIGHEST
`. NUMBER
`PREVIOUSLY
`PAID FOR-
`
`
`
`PRESENT
`_
`
`-.
`
`A
`
`'
`
`,
`
`'
`
`. <
`._
`2
`
`
`
`
`
`
`
`
`
`x $25
`=
`on .
`2
`m m—
`°
`OR
`E
`
`— ——
`2 Appuiwaonsuemm cm 1.1%»
`
`
`_FlRST PRESENTATION OF MULTIPLE DEPENDENT cuuM '(37CFR1.16(1)) u 0.1—-
`'
`TOTAL
`TOTAL -
`ADD'L FEE .
`OR
`ADD'L FEE
`
`
`ADDI-
`RATE ($)
`ADDI-
`
`
`
`
`TIONAL
`TIONAL
`
`
`
`
`
`
`ADD'L FEE
`
`OR
`
`OR
`
`0“
`
`'OR x521o =
`
` X “8 II
`
`
`8370
`
`TOTAL
`ADD'L FEE
`
`(Column 2)
`HIGHEST
`NUMBER
`PREVIOUSLY
`PAID FOR .
`
`(Column 3)
`'
`_
`PRESENT .
`EXTRA
`
`'
`
`
`
`(ceiurnn 1)
`
`REMAINING
`AFTER
`AMENDMENT
`
`
`
` Appliceflon Size Fee (37 CFR 1.16(s))
`
`FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM (37 CFR 1.160))
`
`AMENDMENT3 g
`
`.
`
`.
`
`
`
`
`‘ It the entry in column 1 Is less than the entry In o’oiumn 2. write '0' In column 3.
`" If the “Highest Number Previously Paid For’ IN THIS SPACE lsléss than 20. enter ‘20'.
`‘
`"‘ lithe “Highest Number Previously Paid For' IN THIS SPACE is less than 3. enter'a'f.
`'
`The 'Hi-hest Number PrevioUsi Paid For'
`otal ‘or Inde- -ndent is the hihest number found in the a- uno -riete box in column 1.
`This coiledIOn of information Is required by 37 CFR 1.16. 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‘govemed by 35 U.S.C. 122'and 37.CFR 1.14; This collection is estimated to take 12 minutes to complete,
`Including gathering. preparing. and submitting the completed application tonn'to the USPTO. Time will vary depending upon the individual case. Any comments
`on the amount of time you require to complete this form end/or suggestions for reducing this burden, Should be sent to the Chief lnfonnatlon Otfice‘r. US. Patent
`and Trademark OMce. U.s. Depanment of Commerce. P;O. Box 1450,. Alexandria. VA 22313-1450. 00 NOT SEND FEES OR COMPLETED FORMS TO THIS
`ADDRESS. SEND TO: Commissioner for Patents, P.O. Box 1450, Alexandria. VA 22313-1450.
`.
`
`Ityou need assistance in completing the form, call 1-800-PTO—9199 and select option 2.‘
`
`
`
`
`
`
`
`
`
`