PTO/SB/108 Declaration for Utility or Design Patent Application - S

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PTO/SB/108 (05-16)
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 contains a valid OMB control number.

DEKLARATION FÖR UTILITY ELLER DESIGN PATENT
ANSÖKAN (37 CFR 1.63)
DECLARATION FOR UTILITY OR DESIGN PATENT
APPLICATION (37 CFR 1.63)

D 

Deklaration inlämnad
med ursprunglig
anmälning
Declaration
Submitted
With Initial
Filing

ELLER
OR

D 

Deklaration inlämnad
efter ursprunglig
anmälning
(tilläggskostnad (37
CFR 1.16 (f)) krävs)
Declaration
Submitted After Initial
Filing (surcharge
(37 CFR 1.16(f))
required)

Advokat registreringsnummer
Attorney Docket Number
Först-nämnd uppfinnare
First Named Inventor
FYLL I OM KÄNT
COMPLETE IF KNOWN
ANSÖKNINGSNUMMER
Application Number
REGISTRERINGSDAG
Filing Date
Konstenhet
Art Unit

Granskares namn
Examiner Name

Jag deklarerar härmed att: (1) Varje uppfinnares bostad, postadress, och medborgarskap överensstämmer med vad som skrivits nedan bredvid
personens namn; och (2) Jag tror att uppfinnaren/na som angetts nedan är den ursprungliga och den första uppfinnaren till ämnet som anspråkas och till
vilket en patent sökes för uppfinningen som namnges:
I hereby declare that: (1) Each inventor's residence, mailing address, and citizenship are as stated below next to their name; and (2) I believe the
inventor(s) named below to be the original and first inventor(s) of the subject matter which is claimed and for which a patent is sought on the invention
titled:

(Namn på uppfinningen)
(Title of the Invention)

Ansökan gjordes av mig eller utfärdades på min tillåtelse
the application of which was made or was authorized to be made by me and
härmed
D Bifogas
is attached hereto
ELLER
OR
Registrerades (ÅR/MÅNAD/DAG)

D ansökningsnummer

som USA ansöksnummer eller PCT internationellt
(om tillämpligt)

och ändrades (ÅR/MÅNAD/DAG)

was filed on (MM/DD/YYYY)

as United States Application Number or PCT International Application Number

and was amended on (MM/DD/YYYY)

(if applicable).

Jag intygar härmed att jag har granskat och förstår innehållet av ovanstående nämnda ansökan, däribland anspråken, som ändrade av korrigering, vilket
anges särskilt ovan.
I hereby state that I have reviewed and understand the contents of the above identified application, including the claims, as amended by any amendment
specifically referred to above.
Jag vidkänner ansvaret att avslöja information som är väsentlig för patenerbarhet som definierat av 37 CFR 1.56, däribland för del-förlängning av
ansökningar, väsentlig information som blev tillgänglig mellan registeringsdatumet för den tidigare ansökan och den nationella och PCT internationella
registreringsdatumet för del-förlängningen av ansökan.
I acknowledge the duty to disclose information which is material to patentability as defined in 37 CFR 1.56, including for continuation-in-part applications,
material information which became available between the filing date of the prior application and the national or PCT international filing date of the
continuation-in-part application.

[Sida 1 av 4]
[Page 1 of 4]
This collection of information is required by 35 U.S.C. 115 and 37 CFR 1.63. 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 21 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.

PTO/SB/108 (05-16)
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 contains a valid OMB control number.

DEKLARATION – Utility eller Design Patent Ansokan

DECLARATION — Utility or Design Patent Application

Anspråk på utländsk prioritetsförmåner
Claim of Foreign Priority Benefits
Härmed lämnar jag anspråk på utländska prioritetsförmåner under 35 U.S.C. 119(a)-(d) eller (f), eller 365(b) angående alla utländsk(a) ansökning(ar) för
patent, uppfinnare, eller växtförädlares rättighetscertifikat, eller 365(a) under PCT internationella ansökan som angav åtminstonde ett land utöver USA,
angett under och har även identifierat under, genom at fylla i ladan, alla utländska patentansökningar, uppfinnares, eller växtförädlares rättighetscertifikat,
eller alla PCT internationella ansökningar som har registrerats innan datumet för ansökan där prioritet ges anspråk.

I hereby claim foreign priority benefits under 35 U.S.C. 119(a)-(d) or (f ), or 365(b) of any foreign application(s) for patent, inventor's or plant breeder's
rights certificate(s), or 365(a) of any PCT international application which designated at least one country other than the United States of America, listed
below and have also identified below, by checking the box, any foreign application for patent, inventor's or plant breeder's rights certificate(s), or any PCT
international application having a filing date before that of the application on which priority is claimed.
Certifierad kopia bifogad?
Tidigare Utländska
Utländskt registreringsdatum
Certified Copy Attached?
Ansökningsnummer
Prioritet som inte yrkats
Land
Foreign Filing Date
Prior Foreign Application
JA
NEJ
Priority
Not
Claimed
Country
(MM/DD/YYYY)
Number(s)
YES
NO

D 

D 

D 

D 

D 

D 

D 

D 

D 

D 

D 

D 

D Ytterligare utländska ansökningsnummer är förtecknade på en kompletterande prioritetslista PTO/SB/02B härmed bifogad
Additional foreign application number(s) are listed on a supplemental priority data sheet PTO/SB/02B attached hereto.
[Sida 2 av 4]
[Page 2 of 4]

PTO/SB/108 (05-16)
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 contains a valid OMB control number.

DEKLARATION – Utility eller Design Patent Ansokan

DECLARATION — Utility or Design Patent Application

Rikta all korrespondens
till:
Direct all
Correspondence to:

Adressen tillhörande
kundnummer:
The address
Associated with
Customer Number:

ELLER
OR

D 

Korrespondens address
nedan
Correspondence
address below

D 

Namn
Name
Adress
Address
Stad
City
Land
Country

Delstat
State
Telefon
Telephone

Postnummer
Zip
Epost
Email

VARNING:
WARNING:
Sökande varnas om att vara försiktiga med att lämna ut personuppgifter i handlingar som tillhör en patentansökan, då det kan leda till identitetsstöld.
Personlig information så som personnummer, bankkontonummer eller kreditkortsnummer (förutom godkännande av check eller kreditkort i blanket PTO­
2038 som lämnas in för betalningssyfte) begärs aldrig av USPTO som stöd för en ansökan. Om den här typen av information finns i de handlingar som har
lämnats in till USPTO, bör sökande överväga att redigera sådana personuppgifter innan de lämnar in handlignarna till USPTO. Sökande informeras om att
en patentansökan blir en offentlig handling efter att den har publicerats (förutsatt att ingen begäran om icke-offentliggörande i enlighet med 37 CFR
1.213(a) görs i ansökan) eller efter att patenten har utfärdats. Vidare, en avslagen ansökan kan även bli tillgänglig för allmänheten, om det hänvisas till
denna ansökan i en annan publicerad ansökan eller utfärdad patent (se 37 CFR 1.14). Blankett PTO-2038 för auktorisation av checkar och kreditkort som
lämnas in för betalningssyfte ingår inte i ansökningshandlingen och därmed blir den inte tillgänglig för allmänheten.
Jag intygar härmed att alla uttalande gjorda häri är sanna enligt min egen kunskap och att alla uttalande är gjorda enligt information och övertygelse är
trodda att vara sanna; och vidare att dessa uttlalande gjordes under tron att en uppsätligt falsk uppgift och dylikt är straffbart med böter eller fängelse, eller
båda, enligt 18 U.S.C. 1001 och att sådan uppsåtligt falsk uppgift kan äventyra ansökans giltighet eller en patent som ar utfärdat därpå.
Jag intygar härmed att jag är medveten om att någon uppsåtligt falsk uppgift som är lämnad i denna deklaration är straffbar med böter eller fängelse upp
till fem (5) år enligt U.S.C. 1001, eller båda.
Petitioner/applicant is cautioned to avoid submitting personal information in documents filed in a patent application that may contribute to identity theft.
Personal information such as social security numbers, bank account numbers, or credit card numbers (other than a check or credit card authorization form
PTO-2038 submitted for payment purposes) is never required by the USPTO to support a petition or an application. If this type of personal information is
included in documents submitted to the USPTO, petitioners/applicants should consider redacting such personal information from the documents before
submitting them to the USPTO. Petitioner/applicant is advised that the record of a patent application is available to the public after publication of the
application (unless a non-publication request in compliance with 37 CFR 1.213(a) is made in the application) or issuance of a patent. Furthermore, the
record from an abandoned application may also be available to the public if the application is referenced in a published application or an issued patent
(see 37 CFR 1.14). Checks and credit card authorization forms PTO-2038 submitted for payment purposes are not retained in the application file and
therefore are not publicly available.
I hereby declare that all statements made herein of my own knowledge are true and that all statements made on information and belief are believed to be
true; and further that these statements were made with the knowledge that willful false statements and the like so made are punishable by fine or
imprisonment, or both, under 18 U.S.C. 1001 and that such willful false statements may jeopardize the validity of the application or any patent issued
thereon.
I hereby acknowledge that any willful false statement made in this declaration is punishable under U.S.C. 1001 by fine or imprisonment of not more
than five (5) years, or both.
[Sida 3 av 4]
[Page 3 of 4]

PTO/SB/108 (05-16)
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 contains a valid OMB control number.

DEKLARATION – Utility eller Design Patent Ansokan

DECLARATION — Utility or Design Patent Application


NAMN P Å EGEN ELLER FÖRSTA UPPFINNARE
NAME OF SOLE OR FIRST INVENTOR:
Tilltalsnamn (forsta och mellannamn [om nagot]
Given Name (first and middle [if any])

ansökan has registrerats för denna ounderskrivna uppfinnare
D AEnpetition
has been filed for this unsigned inventor
Familje- eller efternamn
Family Name or Surname

Uppfinnarens underskrift
Inventor’s Signature
Stad
Residence: City

Datum
Date
Delstat
State

Land
Country

Medborgarskap
Citizenship

Delstat
State

Postnummer
Zip

Land
Country

Postadress
Mailing Address
Stad
City

uppfinnare eller juridiskt ombud nämns på
tilläggsblad PTO/SB/02A eller 02LR bifogat här
D Ytterligare
Additional inventors or a legal representative are being named on the
supplemental sheet(s) PTO/SB/02A or 02LR attached hereto
[Sida 4 av 4]
[Page 4 of 4]

OMB Clearance and PRA Burden Statement for PTO/SB/108
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 21 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


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