Form PTO/SB/56 Reissue Application Fee Transmittal Form

PTO/SB/56 (03‐13) 
Approved for use through 08/31/2013. OMB 0651‐0033 
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. 

Docket Number (Optional) 

REISSUE APPLICATION FEE TRANSMITTAL FORM 

Total Claims 
(37 CFR 1.16(i)) 
Ind. Claims 
(37 CFR 1.16(h)) 
Application Size 
Fee 
(37 CFR 1.16(s)) 

Total Claims 
(37 CFR 1.16(i)) 
Ind. Claims 
(37 CFR 1.16(h)) 
Application Size 
Fee 
(37 CFR 1.16(s)) 

Application as Filed – Part 1
Micro Entity

(1) 
Claims 
in 
Patent 

(2) 
Claims Filed 
in Reissue 
Application 

(A) 

(B) 

*                = 

x              = 

(C) 

(D) 

**              = 

x              = 

(3) 
Number 
Extra 

Rate ($)

Fee ($)

Small Entity

Undiscounted

Rate ($)

Fee ($) 

x                 = 

x              = 

x                 = 

x              = 

If the specification and drawings exceed 100 sheets of 
paper, the application size fee due is $400 ($200 for small 
entity, $100 for micro entity) for each additional 50 sheets 
or fraction thereof. See 35 U.S.C. 41(a)(1)(G) and 37 CFR 
1.16(s). 

Filing Fee (37 CFR 1.16(e))
Search Fee (37 CFR 1.16(n))
Examination Fee (37 CFR 1.16(r))
Total Filing Fee 
Application as Amended – Part 2
(1) 
(2) 
(3)
Micro Entity
Claims 
Highest 
Extra 
Rate ($)
Fee ($)
Remaining 
Number 
Claims 
After 
Previously  Present 
Amendment 
Paid For 

Rate ($) 

Fee ($)

Small Entity
Rate ($)

Undiscounted

Fee ($) 

Rate ($) 

Fee ($)

***         

 ‐ 

**** 

= 

x              = 

x                 = 

x              = 

***         

 ‐ 

***** 

= 

x              = 

x                 = 

x              = 

If the specification and drawings exceed 
100 sheets of paper, the application size 
fee due is $400 ($200 for small entity, $100 
for micro entity) for each additional 50 
sheets or fraction thereof. See 35 U.S.C. 
41(a)(1)(G) and 37 CFR 1.16(s). 

Total Additional Fee
*          Enter (B) – 20, or enter “0” if (B) is less than 20.
**        Enter (D) – minus 3, or enter “0” if (D) is less than 3. 
***      After any cancellation of claims. 
****    If the “Highest Number of Total Claims Previously Paid For” is less than 20, enter “20” in this space. 
*****  If the “Highest Number of Independent Claims Previously Paid For” is less than 3, enter “3” in this space. 
          Applicant asserts small entity status. See 37 CFR 1.27. 

          Applicant certifies micro entity status. See 37 CFR 1.29. 
          Form PTO/SB/15A or B or equivalent must either be enclosed or have been submitted previously. 
          The Director is hereby authorized to charge any additional fees under 37 CFR 1.16 or 1.17 which may be required, or credit any 
          overpayment to Deposit Account No. ______________________. 
          A check in the amount of $ __________ to cover the filing/additional fee is enclosed. 
          Payment made via EFS‐Web. 
          Payment by credit card. Form PTO‐2038 is attached. 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. 
          __________________________________________________                    _______________________________________ 
                                           Signature                                                                                                                Date 
          __________________________________________________                    _______________________________________ 
                                  Typed or Printed Name                                                                           Registration Number, if applicable 
                                                                                                                                            _______________________________________ 
                                                                                                                                                                      Telephone Number
This collection of information is required by 37 CFR 1.16. 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, 1.14 and 41.6. 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. SEND 
TO:  Commissioner for Patents, P.O. Box 1450, Alexandria, VA 22313‐1450. 
If you need assistance in completing the form, call 1‐800‐PTO‐9199 and select option 2.

Privacy Act Statement
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. 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.
2. 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.
3. 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.
4. 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).
5. 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.
6. 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)).
7. 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.
8. 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.
9. 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.