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`
`
`
`P635643-02
`
`Panasonic Ref”:
`(* mus! befilled)
`Japan Firm Name: WASHIDA &ASSOCIATES
`US Firm Name:
`GB
`
`Application Serial No.
`
`Japan Firm Ref:
`US Firm Ref:
`
`2F12187-US-P
`
`Declaration Form 3.1 (Jan 2009)
`
`DECLARATION AND POWER OF ATTORNEY FOR US. PATENT APPLICATION
`
`
`
`(c) :1 Substitute
`(d) :l PCT
`(e) E Design
`
`(b) El Supplemental
`
`(a) I Original
`
`l hereby declare that: my residence, post office address and citizenship are as stated
`As 3 below named inventor,
`below next to my name; and I believe that l am the original, first and sole inventor (if only one name is listed below) or an original,
`first and joint inventor (if plural inventors are named below) of the subject matter which is claimed and for which a patent is
`sought on the invention entitled:
`Title of invention:
`
`PHOTOTHERAPY DEVICE
`
`
`
`
`
`
`the attached specification, or
`application filing date
`2. For use when submitting 1le Declaration after US.
`
` Application No. filed on:
`
`
`amiable)
`(numbefilledi
`
`
`
`which is described and claimed in (if the following box is not checked, the specification of which is attached hereto):
`
`1, For use when submitting this Declaration prior to US. a ,licalion film date
`
`(t)
`El
`
`
`the specification in the US.
`(9)
`ii]
`A i'
`t‘ n:
`
`pp ica ‘0 filed on and with amendments (if applicable):
`
`3. For PCT- US national envy under 35 USC. 371 (for use when filing this Declaration before and after the. US nailonaI en
`~
`-
`-
`PCT
`filed on:
`specrfication
`In
`Application No.
`mmmgm)
`the
`(h) I
`r
`International Application:
`(KI/reek hare only/0r US national entry under 35 USC. 37].)
`filed on:
`and with amendments (if applicable):
`
`
`
`
`
`
`
`the
`
`PCT/JP2012I005207
`
`August 20, 2012,
`
`,
`
`I hereby state that I have reviewed and understand the contents of the above-identified specification, including the
`claims, as amended by any amendment(s) referred to above.
`
`l acknowledge my duty to disclose to the US. Patent and Trademark Office all information known to me to be material
`to patentabiiity as defined in Title 37, Code of Federal Regulations, §1 .56.
`
`i hereby claim foreign priority benefits under Title 35, United States Code, §119 (a—d), §172, or §365(b) of any foreign
`application(s) for patent or inventor's certificate, or §365(a) of any PCT international application which designated at least one
`country other than the United States of America, listed below, and have also identified below any foreign application for patent or
`inventor‘s certificate, or of any PCT international application having a filing date before that of the application on which priority is
`claimed:
`
`Fore' n Pn'ori
`Information
`
`COUNTRY
`
`APPLICATION NO.
`
`DATE OF FILING
`
`PRIORITY
`CLAIMED
`
`
`
`20111811155
`
`Augus122,2o11
`
`
`
`El Additional foreign or international application numbers are listed on a supplemental priority sheet attached hereto.
`
`-1-
`
`

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