PTO/SB/17 Fee Transmittal Form

PTO/SB/17 (03‐13) 
Approved for use through 01/31/2014. OMB 0651‐0032 
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 

FEE TRANSMITTAL 
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. 
TOTAL AMOUNT OF PAYMENT 

Complete if known 

Filing Date

First Named Inventor

Examiner Name

Art Unit

Practitioner Docket No.

Application Number

($) 

METHOD OF PAYMENT (check all that apply) 
        Check           Credit Card           Money Order           None           Other (please identify): ___________________________________________ 

        Deposit Account  Deposit Account Number: _______________________  Deposit Account Name: ______________________ 
         For the above‐identified deposit account, the Director is hereby authorized to (check all that apply): 
                     Charge fee(s) indicated below                                                          Charge fee(s) indicated below, except for the filing fee 

                     Charge any additional fee(s) or underpayment of fee(s)             Credit any overpayment of fee(s) 
                     under 37 CFR 1.16 and 1.17 
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. 
FEE CALCULATION 
1.  BASIC FILING, SEARCH, AND EXAMINATION FEES (U = undiscounted fee; S = small entity fee; M = micro entity fee) 

Application Type 
Utility 
Design 
Plant 
Reissue 
Provisional 

U ($) 
280 
180 
180 
280 
260 

FILING FEES 
S ($) 
140* 
90 
90 
140 
130 

M ($) 
70 
45 
45 
70 
65 

U ($)
600
120
380
600
0

SEARCH FEES
S ($)
300
60
190
300
0

M ($)
150
30
95
150
0

EXAMINATION FEES 
U ($)
S ($) 
M ($) 
720
360 
180 
460
230 
115 
580
290 
145 
2,160
1,080 
540 
0
0 
0 

Fees Paid ($)

* The $140 small entity status filing fee for a utility application is further reduced to $70 for a small entity status applicant who files the application via EFS‐Web. 

2.  EXCESS CLAIM FEES 
Undiscounted Fee ($)
Fee Description 

Each claim over 20 (including Reissues) 
80
Each independent claim over 3 (including Reissues) 
420
Multiple dependent claims 
780
Extra Claims
Fee ($)
Fee Paid ($)
Total Claims 

__________
 ‐20 or HP = 
__________ x
__________       =
__________
HP = highest number of total claims paid for, if greater than 20.
Indep. Claims 
Extra Claims
Fee ($)
Fee Paid ($)

__________
 ‐3 or HP = 
__________ x
__________       =
__________
HP = highest number of independent claims paid for, if greater than 3.

Small Entity Fee ($) 
40 
210 
390 

Micro Entity Fee ($)
20
105
195

Multiple Dependent Claims
Fee ($) 
Fee Paid ($)
__________ 
__________

3.  APPLICATION SIZE FEE 
If the specification and drawings exceed 100 sheets of paper (excluding electronically filed sequence or computer listings under 37 CFR 1.52(e)), 
the application size fee due is $400 ($200 for small entity) ($100 for micro entity) for each additional 50 sheets or fraction thereof. See 35 U.S.C. 
41(a)(1)(G) and 37 CFR 1.16(s). 
Extra Sheets 
Number of each additional 50 or fraction thereof
Fee ($) 
Fee Paid ($)
Total Sheets 
__________ ‐ 100 =  __________ / 50 =  __________ (round up to a whole number)          x
__________    = 
__________
4.  OTHER FEE(S) 

Fees Paid ($) 

Non‐English specification, $130 fee (no small or micro entity discount) 

__________ 

Non‐electronic filing fee under 37 CFR 1.16(t) for a utility application, $400 fee ($200 small or micro entity) 

__________ 

Other (e.g., late filing surcharge):  _______________________________________________________________________ 

__________ 

SUBMITTED BY 
Signature 
Name (Print/Type) 

Registration No.
(Attorney/Agent) 

Telephone 
Date 

This collection of information is required by 37 CFR 1.136. 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 1.14. This collection is estimated to take 30 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.