Doc Code: MFEE.C.AD
`
`Document Description: Maintenance Fee Address Change
`
`PTO/SBI47 (10-18)
`Approved for use through 09/30/2021. OMB 0651-0016
`US. Patent and Trademark Office; U. 8. DEPARTMENT OF COMMERCE
`Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number.
`
`“FEE ADDRESS” tNDlCATION FORM
`
`Address to:
`
`Mail Stop M Correspondence
`Commissioner for Patents
`PO. Box 1450
`
`Fax to:
`
`571—273-6500
`
`Alexandria, VA 22313-1450
`
`In addition, only an
`INSTRUCTIONS: The issue fee must have been paid for application(s) listed on this form.
`address represented by a Customer Number can be established as the fee address for maintenance fee
`purposes (hereafter, fee address). A fee address should be established when correspondence related to
`maintenance fees should be mailed to a different address than the correspondence address for the application,
`When to check the first box below: If you have a Customer Number to represent the fee address. When
`to check the second box below: If you have no Customer Number representing the desired fee address,
`in which case a completed Request for Customer Number (PTO/SB/125) must be attached to this form. For
`more information on Customer Numbers, see the Manual of Patent Examining Procedure (MPEP) § 403.
`
`.
`
`For the following listed application(s), please recognize as the “Fee Address" under the provisions of 37 CFR 1.363
`the address associated with:
`
`OR
`
`B The attached Request for Customer Number (PTO/SB/125) form.
`PATENT NUMBER
`(if known)
`
`10,240,614
`
`14/760,853
`
`APPLICATION NUMBER
`
`
`
`Completed by (check one):
`
`DApplicant/lnventor
`
`.
`
`Signature
`
`.Attorney or Agent of record
`
`56047
`(Reg. No.)
`DAssignee of record of the entire interest. See 37 CFR 3.71.
`Statement under 37 CFR 3.73(b) (Form PTO/SB/96) is
`enclosed or was filed on
`
`Brett J. R039“
`~
`Typed or printed name
`610'407'0700
`Requester’s telephone number
`
`(Date)
`
`Date
`
`NOTE: Signatures of all the inventors or assignees of record of the entire interest or their representative(s) are required. If the assignee is a juristic entity,
`this form must be signed by a patent practitioner (attorney or agent) of record. Submit multiple forms if more than one signature is required, see below‘.
`
`forms are submitted.
`E * Total of
`This collection of information is required by 37 CFR 1.363. 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 governed by 35 U.S.C. 122 and 37 CFR 1.11 and 1.14. This collection is estimated to take 5 minutes to complete,
`including gathering, preparing, and submitting the completed application form to the USPTO. Time will vary depending upon the individual case. Any comments on
`the amount of time you require to complete this form and/or suggestions for reducing this burden, should be sent to the Chief Information Officer, US Patent and
`Trademark Office, U.S. Department of Commerce, PO. Box 1450, Alexandria, VA 223134450 DO NOT SEND COMPLETED FORMS TO THIS ADDRESS. SEND
`TO: Mail Stop M Correspondence, Commissioner for Patents, PO. Box 1450, Alexandria, VA 22313-1450.
`If you need assistance in completing the form, call 1-800—PTO-9199 and select option 2.
`
`