PTO/SB/17 (12—04v2)
`Approved for use through 07/31/2006. OMB 0651—0032
`U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
`
`Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays avalid 0M3 control number.
`
`Effective on 12/08/2004
`Fee pursuant to the Consolidated Appropriations Act. 2005 (HR. 4818).
`
`FEE TRANSMITTAL
`
`For FY 2005
`
`u aiiiiaaia aiaiai aaiaii aaiay aaaii saa ii eii —
`TOTAL AMOUNT OF PAYMENT
`$ 1,090.00
`‘ Horney Docket N0
`501 .50379X00
`METHOD OF PAYMENT check all that an 01
`
`g Credit Card D Money Order D None D Other (please identify):
`D Cheek
`g DepOSit Account Deposit Account Number 0 1 '2 1 35 Deposit Account Name Antonelli, Terry, Stout & Kraus, LLP
`The Director is authorized to: (check all that apply)
`D Charge fee(s) indicated below
`g Charge any additional fee(s) or underpayments of fee (s).
`under 37 CFR 1.16 and 1.17
`
`D Charge fee(s) indicated below, except for the filing fee
`g Credit any overpayments
`
`ARNING: Information on this form may become public. Credit card information should not be included on this form. Provide credit card information and authorization on PTO—
`2038.
`FEE CALCULATION
`
`1. BASIC FILING, SEARCH, AND EXAMINATION FEES
`FILING FEES
`SEARCH FEES
`Small Entig
`Small Entig
`Fee{$1
`Fee{$1
`165
`270
`
`Fee{$1
`330
`
`Fee{$1
`540
`
`Application Type
`
`Utility
`
`Design
`Plant
`
`Reissue
`
`Provisional
`
`220
`220
`
`330
`
`220
`
`110
`110
`
`165
`
`1 10
`
`50
`
`100
`330
`
`540
`
`0
`
`2. EXTRA CLAIM FEES
`Fee Description
`Each claim over 20 (including Reissues)
`Each independent claim over 3 (including Reissues)
`Multiple dependent claims
`Extra Claims
`Total Claims
`
`Fee {$1
`
`Fee Paid {$1
`
`EXAMINATION FEES
`Small Entig
`Fee {$1
`110
`
`Fee {$1
`220
`
`70
`85
`
`140
`170
`
`650
`
`0
`
`Fees Paid $
`
`1090.00
`
`Small Entig
`Fee{$1
`Fee {$1
`26
`52
`110
`220
`195
`390
`Multiple Dependent Claims
`Fee {$1
`Fee Paid {$1
`0
`
`(703) 312-6600
`
`
`0
`—20 or HP :
`10
`x
`0
`:
`HP: highest number of total claims paid for, if greater than 20.
`Indep. Claims
`Extra Claims
`Fee {$1
`
`—3 or HP :
`3
`0
`0
`x
`=
`0
`HP:highest number of independent claims paid for, if greater than 3.
`3. APPLICATION SIZE FEE
`If the specification and drawings exceed 100 sheets of paper (excluding electronically filed sequence or computer listings under
`37 CFR 1.52(e)), the application size fee due is $270 ($135 for small entity) for each additional 50 sheets or fraction thereof.
`See 35 U.S.C. 41 (a)(1)(G) and 37 CFR 1.16(s).
`Total Sheets
`Extra Sheets
`Number of each additional 50 or fraction thereof
`
`30
`—100
`0
`/50:
`
`(round up to a whole number) x
`
`Fee Paid {$1
`Fee{$1
`270.00 :
`0
`
`4. OTHER FEE (S)
`Non—English Specification, $130 fee (no small entity discount)
`
`Other (e.g., late filing surcharge):
`
`Fee Paid {$1
`
`SUBMITTED BY
`
`SI ' nature
`
`/M61V111 Kraus/
`
`Registration No.
`(Attorney/Agent)
`
`Complete (ifapplicable)
`
`Telephone
`
`December 4, 2009
`Melvin Kraus
`Name (Print/Type)
`This collection of information is required by 37 CFR 1.136. 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 1.14. This collection is estimated to take 30 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 your require to complete this form and/or suggestions for reducing this burden, should be sent to the Chief
`Information Officer, U.S. Patent and Trademark Office, U.S. Department of Commerce, PO. Box 1450, Alexandria, VA 22313—1450. DO NOT SEND
`FEES OR COMPLETED FORMS TO THIS ADDRESS. SEND TO: 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.
`
`