Form PTO/SB/59 Request for Supplemental Examination Transmittal Form

PTO/SB/59 (07-12)
Approved for use through XXXXXXXX . OMB XXXXXXXXXXX
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.
(Also referred to as FORM PTO-XXXX)

REQUEST FOR SUPPLEMENTAL EXAMINATION TRANSMITTAL FORM

Address to:

Commissioner for Patents
P.O. Box 1450
Alexandria, VA 22313-1450

Attorney Docket No.:
Date:

1.

This is a request for supplemental examination pursuant to 37 CFR 1.610 of patent number _________________
issued ________________________. 37 CFR 1.610(b)(1).

2.

Supplemental examination of claim(s) _______________________________________________is requested.
37 CFR 1.610(b)(4).

3.

a. The name(s) of the patent owner(s) (not the patent practitioner(s)) is (are):
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
b. A submission by the patent owner(s) in compliance with 37 CFR 3.73(c), which establishes that the patent
owner(s) has (have) the entirety of the ownership in the patent for which supplemental examination is
requested, is included. 37 CFR 1.610(b)(9).

4.

a. A check in the amount of $____________ is enclosed to cover the fee for processing and treating a
request for supplemental examination, the fee for reexamination ordered under 35 USC 257, and the fee for
processing and treating each non-patent document over 20 sheets in length (37 CFR 1.20(k)(1 - 3));
b. The Director is hereby authorized to charge all applicable fees as set forth in 37 CFR 1.20(k)(1 - 3)
to Deposit Account No. ________________________; or
c. Payment by credit card. Form PTO-2038 is attached. 37 CFR 1.610(a).

5.

Any refund should be made by
check or
credit to Deposit Account No.__________________.
37 CFR 1.26(c). If payment is made by credit card, refund must be to the credit card account.

6.

A copy of the patent for which supplemental examination is requested, and a copy of any disclaimer or
certificate issued for the patent are included. 37 CFR 1.610(b)(6).

7.

CD-ROM or CD-R in duplicate, Computer Program (Appendix) or large table
Landscape Table on CD

8.

Nucleotide and/or Amino Acid Sequence Submission
If applicable, items a. – c. are required.
a.
Computer Readable Form (CRF)
b. Specification Sequence Listing on:
i.
ii.
c.

9.

CD-ROM (2 copies) or CD-R (2 copies); or
paper

Statements verifying the identity of above copies

A list of no more than 12 items of information submitted as part of this request is provided in Part B of this form.
Where appropriate, the list must meet the requirements of 37 CFR 1.98(b). 37 CFR 1.605(a), 1.610(b)(2).

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This collection of information is required by 37 CFR 1.610. 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 18 minutes to complete, including
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
gathering,
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.

Patent No.

PTO/SB/59 (07–12)
Approved for use through xxxxxx. OMB xxxxxxxxxxxx
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.

_______

10.

A legible copy of each item of information listed in Part B of this form, and an English language translation of all necessary

  and pertinent parts of each non-English language item of information are included.

part of the discussion within the body of the request (see 37 CFR 1.605(b)), and
  Copies of items of information that form

copies of U.S. patents and patent application publications, are not required. 37 CFR 1.610(b)(7).

11.

A summary of the relevant portions of each non-patent document that is over 50 pages in length (other than the request) is
included. The summary includes the required citations to the particular pages containing the relevant portions. 37 CFR
1.610(b)(8).

12.

A separate, detailed explanation of the relevance and manner of applying each item of information to each claim of the
patent for which supplemental examination is requested, is included. 37 CFR 1.610(b)(5).

13.

The below list includes all prior or concurrent post-patent Office proceedings (ex parte or inter partes reexamination, reissue,
supplemental examination, post grant review, or inter partes review) involving the patent for which supplemental examination
is being requested. 37 CFR 1.610(b)(3). An identifying number may be, e.g., a control no. or reissue application no. Any
prior or concurrent post-patent Office proceedings not listed below are listed on a separate paper accompanying the request.
Type of Proceeding

Identifying Number

Filing Date

_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
See accompanying paper for a list of additional prior or concurrent post-patent Office proceedings involving the patent for
which supplemental examination is requested. The paper should be a separate sheet titled “List of Prior or Concurrent PostPatent Office Proceedings” and must provide the type, identifying number, and filing date of the post-patent Office proceeding.
14. Correspondence Address: Please recognize, or change, the correspondence address for the file of the patent for which
supplemental examination is requested and for the supplemental examination proceeding to be:
OR

The address associated with Customer Number:
Firm or
Individual Name
R
Address

City

State

Zip

Country
Telephone

Email

15. WARNING: Information on this form may become public. Credit card information should not be included on this form.
Provide credit card information and authorization on PTO-2038.
_________________________________________________
Authorized Signature

___________________________
Date

__________________________________________________
Typed/Printed Name

___________________________
Registration No.

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PTO/SB/59 (07-12)
Approved for use through XXXXXXXX . OMB XXXXXXXXXXX
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.
(Also referred to as FORM PTO-XXXX)

REQUEST FOR SUPPLEMENTAL EXAMINATION TRANSMITTAL FORM
PART B – LIST OF ITEMS OF INFORMATION – Page 1

Patent number
for which supplemental examination
is requested ___________________

Issue Date ______________

All items of information (no more than 12) submitted herewith as part of this request for supplemental
examination of the above-identified patent are included in the following list:
Cite
No.1

Document Number
Number-Kind Code2 (if
known)

US-

Publication
Date
MM-DDYYYY

U. S. PATENT DOCUMENTS
Name of Patentee or
Applicant of Cited Document

Pages, Columns, Lines, Where
Relevant Passages or Relevant
Figures Appear

USUSUSUSUSUSUSUSUSUSUSCite
No.1

Foreign Patent
Document
Country Code3-Number4Kind Code5 (if known)

Publication
Date
MM-DDYYYY

FOREIGN PATENT DOCUMENTS
Name of Patentee or
Applicant of Cited Document

Pages, Columns, Lines, Where
Relevant Passages or
Relevant Figures Appear

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1
Applicant’s unique citation designation number (optional). 2 See Kinds Codes of USPTO Patent Documents at www.uspto.gov or MPEP 901.04. 3 Enter Office that issued
the document, by the two-letter code (WIPO Standard ST.3). 4 For Japanese patent documents, the indication of the year of the reign of the Emperor must precede the serial
number of the patent document. 5Kind of document by the appropriate symbols as indicated on the document under WIPO Standard ST.16 if possible. 6 Applicant is to place a
check mark here if English language Translation is attached.

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PTO/SB/59 (07-12)
Approved for use through XXXXXXXX . OMB XXXXXXXXXXX
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.
(Also referred to as FORM PTO-XXXX)

REQUEST FOR SUPPLEMENTAL EXAMINATION TRANSMITTAL FORM

PART B – LIST OF ITEMS OF INFORMATION – Page 2

Patent number for which supplemental examination is requested ___________________
Issue Date ______________
All items of information (no more than 12) submitted herewith as part of this request for supplemental
examination of the above- identified patent are included in the following list:
OTHER DOCUMENTS
Cite
No.1

1

Document Information (include, where appropriate, name of the author, title of the article, book, magazine, journal, serial, symposium, catalog, etc.,
publication date, page(s), volume-issue number(s), publisher, city and/or country where published. If a court document, identify the specific court, the
designation (case citation or numeric designation), the title of the document, and the date submitted in court. If a declaration, include the type (e.g., 37
CFR 1.132 or 1.131), name of declarant, and the date of declaration. If an invoice or sales receipt, include the date issued and the name of the issuer
(e.g., the name of the corporation or other place of business). If a discussion within the body of the request, include the pages of the request on which
the discussion appears, and a description of the discussion (e.g., “discussion in request of why the claims are patentable under 35 U.S.C. 101, pages
7-11.”) For all other materials, include, where appropriate, the title, author, date, and any descriptive information that would describe the document.)

Applicant’s unique citation designation number (optional). 2 Applicant is to place a check mark here if English language Translation is attached.

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T2