`Substitute for Form PTO-875
`
`Application or Docket Number
`17/146,243
`
`APPLICATION AS FILED - PART|
`(Column 1)
`(Column 2)
`
`SMALL ENTITY
`
`OTHER THAN
`SMALL ENTITY
`
`BASIC FEE
`(37 CFR 1.16(a), (b), or (c))
`SEARCH FEE
`(37 CFR 1.16(K), (i), or (m))
`SCNas en
`(37 CFR 1.16(0
`
`If the specification and drawings exceed 100
`APPLICATION SIZE_|sheets of paper, the application size fee due is
`FEE
`$310 ($155 for small entity) for each additional
`(37 CFR 1.16(s))
`50 sheetsor fraction thereof. See 35 U.S.C.
`41(a)(1)(G) and 37 CFR 1.16(s).
`
`MULTIPLE DEPENDENT CLAIM PRESENT(37 CFR 1.16(j))
`
`* If the difference in column 1 is less than zero, enter "0" in column 2.
`
`TOTAL
`
`The "Highest Number Previously Paid For" (Total or Independent) is the highest found in the appropriate box in column 1.
`
`is less than the entry in column 2, write "0" in column 3.
`* |f the entry in column 1
`* If the "Highest Number Previously Paid For” IN THIS SPACE is less than 20, enter "20".
`** If the "Highest Number Previously Paid For” IN THIS SPACE is less than 3, enter "3".
`
`APPLICATION AS AMENDED - PARTII
`
`(Column 1)
`CLAIMS
`REMAINING
`AFTER
`AMENDMENT
`
`(Column 3)
`
`(Column 2)
`HIGHEST
`NUMBER
`PREVIOUSLY
`PAID FOR
`
`Total
`(37 CFR 1.16(i))
`Independent
`(37 CFR 1.16(h))
`
`Application Size Fee (37 CFR 1.16(s))
`
`FIRST PRESENTATION OF MULTIPLE DEPENDENTCLAIM (37 CFR 1.16(j))
`
`(Column 1)
`CLAIMS
`REMAINING
`AFTER
`AMENDMENT
`
`(Column 2)
`HIGHEST
`NUMBER
`PREVIOUSLY
`PAID FOR
`
`(Column 3)
`
`PRESENT
`EXTRA
`
`Total
`(37 CFR 1.16(i))
`Independent
`(37 CFR 1.16(h))
`Application Size Fee (37 CFR 1.16(s))
`
`FIRST PRESENTATION OF MULTIPLE DEPENDENTCLAIM (37 CFR 1.16(j))
`
`AMENDMENTA
`
`AMENDMENTB
`
`OTHER THAN
`
`SMALL ENTITY
`ADDITIONAL
`FEE($)
`
`ADDITIONAL
`FEE($)
`
`