Draft Issue Fee Transmittal Form for EFS-Web

PTOL-85B
Approved for use by OMB through MM/DD/YYYY OMB xxxx-xxxx
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.
Issue Fee Transmittal

Application Number

(enter EFS-Web Document description)

Filing Date
First Named Inventor
Attorney Docket Number
Examiner Name
Art Unit
Class-Subclass

Title of Invention:
Appln. Type

Small Entity

Issue Fee Due

Publication Fee
Due

Prev. Paid Issue
Fee

Total Fee(s) Due

Date Due

Instructions: this form should be used for transmitting the ISSUE FEE and PUBLICATION FEE (if required). Blocks 1 through 5 should be completed where
appropriate. All further correspondence including the Patent, advance orders and notification of maintenance fees will be mailed to the current correspondence
address as indicated unless corrected below or directed otherwise in Block 1, by 9a) specifying a new correspondence address and/or 9b) indicating a separate
“FEE ADDRESS’ for maintenance fee notification.
Change of Correspondence Address or Change of Maintenance Fee Address (37 CFR 1.363)
Use Current Address
Change of Correspondence Address form PTO/SB/122
Change Maintenance Fee Address PTO/SB/47
attached
form attached
Name
Address
St/Province
Country
Postal
City
For Printing on the front page of the patent list
(1) the names of up to 3 registered patent attorneys or agents
(2) the name of a single firm (having as a member a registered attorney or agent) and the names of up to 2 registered patent attorneys of agents If
no name is listed, no name will be printed.
Name 1
Name 2
Name 3
ASSIGNEE NAME AND RESIDENCE DATA TO BE PRINTED ON THE PATENT
Name 2
Name 1
Address 1
Address 2
State/Province
Country
City
Please check the appropriate assignee category or categories (will not be printed on patent)
Blank
The following fee(s) are submitted:
Issue Fee
Publication Fee (No small entity discount permitted)
Advance Order of Copies
Change in Entity Status (from status indicated above)
SMALL ENTITY
Applicant claims or has previously claimed, small entity status. See 37 CFR 1.27.
LOSS OF ENTITLEMENT TO SMALL ENTITY STATUS.
Applicant is no longer entitled to Small Entity Status. See 37 CFR 1.27(g).
The Issue Fee and Publication Fee will not be accepted from anyone other than the applicant; a registered attorney or agent; or the assignee or other party of
interest as shown by records of the United States Patent and Trademark Office. This portion must be completed by the Signatory or Signatories
I certify, that in accordance to 37 CFR 1.4(d)(4) that I am
An attorney or agent registered to practice before the Patent and Trademark Office
A sole applicant
A joint applicant; I certify that I am authorized to sign this submission on behalf of all the other patentees
A joint applicant; all of whom are signing this Issue Fee Transmittal
The assignee of record of the entire interest
Patent Practitioner
A signature of the applicant or representative is required in accordance with 37 CFR 1.33 and 10.18. Please see 37 CFR 1.4(d) for the form of the signature.
Signature
Date
Name
Registration Number
Sole Applicant
Signature
Date
Name
A joint applicant and I certify that I am authorized to sign this submission for all the other applicants
Signature
Date
Name
A joint applicant all of whom are signing this Issue Fee
Signature
Date
This collection of information is required by 37 CFR 1.311. 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 1.11 and 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, U.S. Patent and Trademark Office, U.S. Department of Commerce, P.O. Box 1450, Alexandria, VA 22313-1450. DO NOT SEND FEES OR COMPLETED FORMS TO THIS ADDRESS. This form can
only be used when in conjunction with EFS-Web. If this form is mailed to the USPTO, it may cause delays in processing your request.

PTOL-85B
Approved for use by OMB through MM/DD/YYYY OMB xxxx-xxxx
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.
Name
Signature
Name
Enter Reel and Frame Number
Reel Number
Click Add for additional Reel and Frame Numbers

The assignee of record of the entire interest
Date
Remove
Frame Number
Add

This collection of information is required by 37 CFR 1.311. 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 1.11 and 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, U.S. Patent and Trademark Office, U.S. Department of Commerce, P.O. Box 1450, Alexandria, VA 22313-1450. DO NOT SEND FEES OR COMPLETED FORMS TO THIS ADDRESS. This form can
only be used when in conjunction with EFS-Web. If this form is mailed to the USPTO, it may cause delays in processing your request.

.

The Privacy Act of 1974 (P.L. 93-579) requires that you be given certain information in connection with your submission
of the attached form related to a patent application or patent. Accordingly, pursuant to the requirements of the Act, please
be advised that: (1) the general authority for the collection of this information is 35 U.S.C. 2(b)(2); (2) furnishing of the
information solicited is voluntary; and (3) the principal purpose for which the information is used by the U.S. Patent and
Trademark Office is to process and/or examine your submission related to a patent application or patent. If you do not
furnish the requested information, the U.S. Patent and Trademark Office may not be able to process and/or examine your
submission, which may result in termination of proceedings or abandonment of the application or expiration of the patent.
The information provided by you in this form will be subject to the following routine uses:
1.

2.

3.

4.

5.

6.
7.

8.

9.

The information on this form will be treated confidentially to the extent allowed under the Freedom of Information
Act (5 U.S.C. 552) and the Privacy Act (5 U.S.C 552a). Records from this system of records may be disclosed to
the Department of Justice to determine whether disclosure of these records is required by the Freedom of
Information Act.
A record from this system of records may be disclosed, as a routine use, in the course of presenting evidence to
a court, magistrate, or administrative tribunal, including disclosures to opposing counsel in the course of
settlement negotiations.
A record in this system of records may be disclosed, as a routine use, to a Member of Congress submitting a
request involving an individual, to whom the record pertains, when the individual has requested assistance from
the Member with respect to the subject matter of the record.
A record in this system of records may be disclosed, as a routine use, to a contractor of the Agency having need
for the information in order to perform a contract. Recipients of information shall be required to comply with the
requirements of the Privacy Act of 1974, as amended, pursuant to 5 U.S.C. 552a(m).
A record related to an International Application filed under the Patent Cooperation Treaty in this system of
records may be disclosed, as a routine use, to the International Bureau of the World Intellectual Property
Organization, pursuant to the Patent Cooperation Treaty.
A record in this system of records may be disclosed, as a routine use, to another federal agency for purposes of
National Security review (35 U.S.C. 181) and for review pursuant to the Atomic Energy Act (42 U.S.C. 218(c)).
A record from this system of records may be disclosed, as a routine use, to the Administrator, General Services,
or his/her designee, during an inspection of records conducted by GSA as part of that agency’s responsibility to
recommend improvements in records management practices and programs, under authority of 44 U.S.C. 2904
and 2906. Such disclosure shall be made in accordance with the GSA regulations governing inspection of
records for this purpose, and any other relevant (i.e., GSA or Commerce) directive. Such disclosure shall not be
used to make determinations about individuals.
A record from this system of records may be disclosed, as a routine use, to the public after either publication of
the application pursuant to 35 U.S.C. 122(b) or issuance of a patent pursuant to 35 U.S.C. 151. Further, a record
may be disclosed, subject to the limitations of 37 CFR 1.14, as a routine use, to the public if the record was filed
in an application which became abandoned or in which the proceedings were terminated and which application is
referenced by either a published application, an application open to public inspection or an issued patent.
A record from this system of records may be disclosed, as a routine use, to a Federal, State, or local law
enforcement agency, if the USPTO becomes aware of a violation or potential violation of law or regulation.