Doc Code: RFN.REQ
`Approved for use through 03/31/20
`Document Description Refund
`US. Patent and Traclernark Gifice; US. DEPARTMENT OF COMM
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`Under the Paperwork Reduction Act of 1995, no persans are required to respondtea collection of information unless it displays a valid OME control number.
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`Reference © Potent } Application
`Trodeinark Serial, Registration # etc)
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`REQUEST FOR REFUND
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`Title of Invention or Mark Information
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`15/563,511
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`NONCONTACT POWER SUPPLY DEVICE AND CONTROL DEVICE THEREFOR
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`Acttomey Docket # Gupplicabie)
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`Payment Date inavddivi)
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`Refund Request Amount
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`083770-1816
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`10/27/2022
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`% 1,680.00
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`Refund Option (elect one}
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`if approved, issue the refund to the account associated with the original payment.
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`if approved, and the original payment was a check, issue the refund to deposit account#.
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`if approved, and the original payment was a check, issue the refund as a U.S. Treasury check.
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`Reason for Refund Request hefund requests must cenerally be filed within 2 years ofeayment date (G7 CFR 1.26 anu 2.208)
`| Duplicate Payment
`[| No Fee Due
`Office Error
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`Small Entity Later Established*
`(must be filed within 3 months of oayment date, 37 CFR 1.28)
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`Rationale Gupporting dacumentation maybe subnutied withthis form)
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`Requester’s Information
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`Company or Firm Name @applicable)
`McDermott Will & Emery LLP
`ey =eS
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`Address Line 7
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`On August 16, 2022, Applicant filecl a 2 month EOT for the Appeal Brief which was due on June 18,
`2022. However, the USTPTO inadvertently charged our deposit account $1680.00 on October 27,
`2022 (effective date August 16, 2022) for a 4 month EOT. Please refund the $1,680.00 to Deposit
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`Account 5004177.
`Reguesters Name
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`500 North Capitol St, NW
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`Washington
`Country
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`DC
`Zip/Postal Code
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`fpanacncnnshinsnsnsnrdpacesesnans
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`ipdocketmwe@mwe.com
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`Signature
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`Takashi Saito
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`{Takashi Saito/
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`Phone Nuniber
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`202-756-8000
`Registration Number
`Uf apalcabiey
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`69,536
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`Date onmdd4jai44
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`03/03/2023
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`he
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`3 (registered users onlyc select "Request for Refund" from the document description menu), or
`Submit online:
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`Fax fo: 571-273-6506, or
`Mail to: Mail Stop 16, Director of the U.S. Patent and Trademark Office, P.O. Box 1450, Alexandria, VA 22313-1450
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