PTO-2326 (04-2019)
`Doc Code: RFN.REQ
`Approved for use through 03/31/2021. OM8 0637-9043
`Document Description Refund
`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 a valid OMB control number.
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`Reference # (Patent #, Application #,
`Trademark Serial #, Registration: #, etc)
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`REQUEST FOR REFUND
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`Title of Invention or Mark Information
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`16/847,133
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`INTEGRATED CIRCUIT
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`Attorney Docket # (applicable)
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`Payment Date (mm/ddvyywy)
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`Refund Request Amount
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`733456.582C6
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`$ 300.00
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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 wasa 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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`
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`April 20, 2020 is not applicable. Please credit the refund to Deposit Account No. 19-1090, referencing our Docket No. 733456.582C6.
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`Email Address
`(Youll receive an acknomedgment ofreceipt onlyif-you provide-a valid email address)
`patentinfo@seedip.com
`Requester's Name
`
`Reason for Refund Request Refund requests must generally befiled within 2 years ofpayment date (27 CFR 1.26 and 2.209)
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`[| Duplicate Payment [ No Fee Due
`Small Entity Later Established*[] Other
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`(*must befiled within 3 months of paymentdate, 37 CFR 1.28)
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`}
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`Rationale (Supporting documentation may be submitted with this form)
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`The present application includes twenty-five (25) total claims. On April 13, 2020, applicant paid $460 for one (1) excess independentclaim,
`and paid $500forfive (5) excess dependentclaims. Thus, Applicant has paid forall five (5) excess dependent claims and the one(1) excess
`independentclaim. Accordingly, Applicant has duly paid forall of the excess claims in a timely manner, and the $300 surcharge made on
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`Requester’s Information
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`Address Line 2° (f applicable}
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`WA
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`Zip/Postal Code
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`Suite 5400
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`U.S.
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`98104
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`Phone Number
`206.622.4900
`Registration Number
`(if applicable}
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`43,746
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`04/21/2020
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`ShokoI. Leek
`
`/Shoko Leek/
`
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`Submit online: £F5-Web (registered users only; select "Request for Refund" from the documentdescription menu), or
`Fax to: 571-273-6500, or
`Mail to: Director of the U.S. Patent and Trademark Office, Attn: Refunds, 2051 Jamieson Avenue, Suite 300, Alexandria, VA 22314
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`