Form PTO/SB/17 Fee Transmittal Form

PTO/SB/17 (02-07)
Approved for use through XX/XX/XXXX. 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

Doc Code:

Complete if Known

Effective on 12/08/2004.
Fees pursuant to the Consolidated Appropriations Act, 2005 (H.R. 4818).

Application Number

FEE TRANSMITTAL

Filing Date

For FY 2007

First Named Inventor
Examiner Name

Applicant claims small entity status. See 37 CFR 1.27
TOTAL AMOUNT OF PAYMENT

Art Unit

($)

Attorney Docket No.

METHOD OF PAYMENT (check all that apply)

Check

Credit Card

Deposit Account

Money Order

Other (please identify):______________________

None

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 underpayments of fee(s)
under 37 CFR 1.16 and 1.17

Credit any overpayments

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
FILING FEES
SEARCH FEES
Application Type

Small Entity
Fee ($)
Fee ($)

Small Entity
Fee ($)
Fee ($)

Utility
Design
Plant
Reissue
Provisional

300
200
200
300
200

500
100
300
500
0

150
100
100
150
100

250
50
150
250
0

2. EXCESS CLAIM FEES

EXAMINATION FEES
Fee ($)

200
130
160
600
0

Small Entity
Fee ($)

50
200
360

Each claim over 20 (including Reissues)
Each independent claim over 3 (including Reissues)
Multiple dependent claims
Total Claims
Extra Claims
Fee ($)
Fee Paid ($)
__________ - 20 or HP = ___________ x __________ = ___________
HP = highest number of total claims paid for, if greater than 20.

Indep. Claims
__________ - 3 or HP =

____________
____________
____________
____________
____________

100
65
80
300
0
Fee ($)

Fee Description

Extra Claims
Fee ($)
Fee Paid ($)
____________ x __________ = ___________

Fees Paid ($)

Small Entity
Fee ($)

25
100
180

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

___________

HP = highest number of independent claims paid for, if greater than 3.

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 $250 ($125 for small 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 Sheets
__________ - 100 =

Number of each additional 50 or fraction thereof
Extra Sheets
___________ (round up to a whole number) x
___________ / 50 =

Fee ($)
Fee Paid ($)
__________ = ___________

4. OTHER FEE(S)

Non-English Specification, $130 fee (no small entity discount)
Other (e.g., late filing surcharge):__________________________________________________

Fees Paid ($)

____________
____________

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 Administrative 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.

OMB Clearance and PRA Burden Statement for PTO/SB/17
This collection of information is required by 37 CFR 1.137. 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 form is estimated to
take 30 minutes to complete, including gathering, preparing, and submitting the completed 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 Administration 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: Mail Stop Petition, Commissioner for Patents, P.O. Box 1450, Alexandria, VA
22313-1450.

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. The United States Patent and Trademark Office (USPTO) collects this information under authority of 5 CFR 339.205.
The information in this system of records is used to manage all records of applicant including name, citizenship, residence, post office address and
other information pertaining to the applicant's activities in connection with the invention for which a patent is sought. Statements containing various
kinds of information with respect to inventors who are deceased or incapacitated, or who are unavailable or unwilling to make application for patent.
The information obtain is protected from disclosure to third parties in accordance with the Privacy Act.
However, routine uses of this information may include disclosure to the following: to law enforcement and investigation in the event that the system
of records indicates a violation or potential violation of law; to a Federal, state, local, or international agency, in response to its request; to an agency,
organization, or individual for the purpose of performing audit or oversight operations as authorized by law; to non-federal personnel under contract
to the agency; to a court for adjudication and litigation; to the Department of Justice for Freedom of Information Act (FOIA) assistance; to members of
congress working on behalf of an individual; to the Office of Personnel Management (OPM) for personnel research purposes; to National Archives and
Records Administration for inspection of records; and to the Office of Management and Budget (OMB)for legislative coordination and clearance.
Failure to provide any part of the requested information may result in an inability to process requests for access and information. The applicable
Privacy Act System of Records Notice for this information is COMMERCE/PAT-TM-7 Patent Application Files, available at Federal Register /Vol. 78, No.
61 / Friday, March 29, 2013 /Notices 19243. https://www.govinfo.gov/content/pkg/FR-2013-03-29/pdf/2013-07341.pdf