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`U.S. Palani and Trademark Office:
`§. DEPARTMENT OF COMMERCE
`Under the Paserwork Reduction Act of 1985, no Samoans are es
`idisosiays a valid OMS control number.
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`f “DECLARATION (27 CFR 1.63) FOR UTILITY OR DESIGN APPLICATION USING AN
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`As the below named inventor, | hereby declare that:
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`This declaration
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`["] The attached applicaiian, or
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`United States application or PCT international application number PCTAP201g2e29t7_
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`Hed on June10.2019.
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`The above-identified application was made or authorized to be made by me.
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`thelieve thal | am the original inventor or an original joint inventor of a claimed invention in the apolication,
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`i hereby acknawhodge that any willful fase ateternent mace in this declaration is punishable under 18 ULS.C. 1004
`by fine or imprisonment of not more than five (8) years, or both.
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`WARNING:
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`Patitionerfarplicant is cautioned to aveld submitting personal information in documents filed in a patent apglication that may
`contribute to identity theft. Personal information such as social security numbers, bank account numbers, or credit card nurnbers
`{other than @ check or credil card authorization form PTO-2098 submitted for payment pursoses} is never required by the LISPTO
`iG support a petition or an application. tf this type of personal information is included in documents submitted to the USPTO,

`i pettionars/applicants should consider redacting such personal information frorn the documents before submitting them to the
`i USPTO, Patiionervfapplicant is advisad that the racord of a patent application is available to ihe public after publication of the
`i application: (untass a ron-publication request in corapliance with 27 CFR 4.213(a) is made in the application) or issuance of a
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`Note: An application data sheet (PTO/SB414 or equivalent), including naming the entire inventive entity, must accompany this form:
`3 Use an additional PTOVALAMH form for each additional inventor,
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`This collection of information is required by 46 U.S.C. 115 ane 37 CPR 1.64, The information is required to obtain or retain e benefit by ine public whichis to file Gand
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`by the USPTO to process} an applicetion..cCaniida
`ty is governed by 46 U.S.C. 1722 and 4Y CFR 1.41 and 1.44. This collection is estimated to fake 1 minute fo
`complete, including gathering preparing, and subrnitting the completed application form to the USPTO, Time will very depending uparn the individual case. Any
`camments on the amount of time you require in carmpiete thie torn andor suggestions for reducing this burden, should be sent te the Chief information Officer, US
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`you need aagisiance in completing the form, call 1-B00-0'TO-9798 and sefect apton 2
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