PTO/SB/06 (09-11)
`Approved for use through 1/31/2014. OMB 0651-0032
`US. Patent and Trademark Office; US. 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.
`
`PATENT APPLICATION FEE DETERMINATION RECORD
`Substitute for Form PTO-875
`
`Application or DOCke‘ Number
`14/414,167
`
`Filing Dale
`01/12/2015
`
`I: To be Mailed
`
`APPLICATION AS FILED — PART I
`
`(Column 1)
`
`(Column 2)
`
`ENTITY:
`
`IXI LARGE |:| SMALL |:| MICRO
`
`37CFR1.16a, b,or c
`
`37CFR1.16k,
`
`i,or m
`
`I] EXAMINATION FEE
`
`TOTAL CLAIMS
`37 CFR1.16i
`INDEPENDENT CLAIMS
`37 CFR1.16h
`
`DAPPLICATION SIZE FEE
`(37 CFR1.16(s))
`
`*
`
`*
`
`,
`”Imus 20:
`,
`”WU“:
`If the specification and drawings exceed 100 sheets
`of paper, the application size fee due is $310 ($155
`for small entity) for each additional 50 sheets or
`fraction thereof. See 35 U.S.C. 41(a)(1)(G) and 37
`CFR 1.16(s).
`
`
`
`El MULTIPLE DEPENDENT CLAIM PRESENT (37 CFR1.16(j))
`* If the difference in column 1 is less than zero, enter “0" in column 2.
`
`APPLICATION AS AMENDED — PART II
`
`CLAIMS
`
`:‘IEngNING
`AMENDMENT
`
`(Column 2)
`
`HIGHEST
`
`IPIRIIEAaOFLIJSLY
`PAID FOR
`
`.. 20
`
`(Column 3)
`
`PRESENT EXTRA
`
`ADDITIONAL FEE ($)
`
`D Application Size Fee (37 CFR1.16(S))
`
`D FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM (37 CFR1.16(j))
`
`CLAIMS
`REMAINING
`AFTER
`AMENDMENT
`
`-
`
`HIGHEST
`NUMBER
`PREVIOUSLY
`PAID FOR
`
`PRESENT EXTRA
`
`1.160))
`
`(37 CFR1.16(h))
`
`Minus
`
`***
`
`El Application Size Fee (37 CFR1.16(s)
`
`D FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM (37 CFR1.16(j))
`
`AMENDMENT
`
`AMENDMENT
`
`* If the entry in column 1 is less than the entry in column 2, write “0" in column 3.
`** If the “Highest Number Previously Paid For" IN THIS SPACE is less than 20, enter “20".
`*** If the “Highest Number Previously Paid For" IN THIS SPACE is less than 3, enter “3
`The “Highest Number Previously Paid For" (Total or Independent) is the highest number found in the appropriate box in column 1.
`This collection 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 governed 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 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, US.
`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, P.O. Box 1450, Alexandria, VA 22313-1450.
`If you need assistance in completing the form, call 1-800—PTO-9199 and select option 2.
`
`LIE
`AMANDA FORD
`
`